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[镁与支气管肺发育不良]

[Magnesium and bronchopulmonary dysplasia].

作者信息

Fridman Elena, Linder Nehama

机构信息

Department of Pediatrics A, Schneider Children's Medical Center of Israel, Petach Tikva.

出版信息

Harefuah. 2013 Mar;152(3):158-61, 182.

Abstract

Bronchopulmonary dysplasia (BPD) is a chronic lung disease that occurs in premature infants who have needed mechanical ventilation and oxygen therapy. BPD is defined as the presence of persistent respiratory symptoms, the need for supplemental oxygen to treat hypoxemia, and an abnormal chest radiograph at 36 weeks gestational age. Proinflammatory cytokines and altered angiogenic gene signaling impair prenatal and postnatal lung growth, resulting in BPD. Postnatal hyperoxia exposure further increases the production of cytotoxic free radicals, which cause lung injury and increase the levels of proinflammatory cytokines. Magnesium is the fourth most abundant metal in the body. It is commonly used for the treatment of preeclamsia, as well as for premature labor alleviation. Magnesium's role in BPD development is not clear. A significant association between high magnesium levels at birth and respiratory distress syndrome (RDS), pulmonary interstitial emphysema in the extremely low birth weight, respiratory failure, and later development BPD was found. Conversely, low magnesium intake is associated with lower lung functions, and hypomagnesemia was found in 16% of patients with acute pulmonary diseases. Magnesium is used for the treatment of asthmatic attacks. Magnesium deficiency in pregnant women is frequently seen due to low intake. Hypomagnesemia was also found among preterm neonates and respiratory distress syndrome (RDS). Experimental hypomagnesemia evokes an inflammatory response, and oxidative damage of tissues. These were accompanied by changes in gene expression mostly involved in regulation of cell cycle, apoptosis and remodeling, processes associated with BPD. It is rational to believe that hypomagnesemia can contribute to BPD pathogenesis.

摘要

支气管肺发育不良(BPD)是一种发生于需要机械通气和氧疗的早产儿的慢性肺部疾病。BPD的定义为在孕36周时存在持续的呼吸道症状、需要补充氧气以治疗低氧血症以及胸部X线片异常。促炎细胞因子和血管生成基因信号改变会损害产前和产后肺的生长,从而导致BPD。出生后暴露于高氧环境会进一步增加细胞毒性自由基的产生,这些自由基会导致肺损伤并增加促炎细胞因子的水平。镁是体内含量第四丰富的金属。它常用于治疗先兆子痫以及缓解早产。镁在BPD发生发展中的作用尚不清楚。研究发现出生时高镁水平与呼吸窘迫综合征(RDS)、极低出生体重儿的肺间质肺气肿、呼吸衰竭以及后期发生BPD之间存在显著关联。相反,低镁摄入与较低的肺功能相关,并且在16%的急性肺部疾病患者中发现了低镁血症。镁用于治疗哮喘发作。由于摄入不足,孕妇中经常出现镁缺乏。在早产儿和呼吸窘迫综合征(RDS)中也发现了低镁血症。实验性低镁血症会引发炎症反应和组织的氧化损伤。这些伴随着主要参与细胞周期调控、细胞凋亡和重塑(与BPD相关的过程)的基因表达变化。有理由认为低镁血症可能促成BPD的发病机制。

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