James D, Berry P J, Fleming P, Hathaway M
Southmead Hospital, Bristol.
Arch Dis Child. 1990 Jul;65(7):774-8. doi: 10.1136/adc.65.7.774.
A prospective study of 46 infant deaths occurring between 3 and 100 weeks of age was performed and comprised a structured necropsy followed by collection of lung washings for surfactant phospholipid analysis and samples for microbiological examination. Of the 46 infants studied, 23 died from sudden infant death syndrome (SIDS) alone; SIDS was the cause of death in a further 12 but there were additional clinical or pathological findings insufficient in themselves to account for the death ('SIDS-plus'). In 11 there were other causes of death ('non-SIDS'). The lung washings from infants dying from SIDS had significantly lower concentrations of phosphatidylcholine and a significantly lower palmitate content in the phosphatidylcholine. There was no association between surfactant phospholipid abnormality and the presence of recognised pathogens, histological evidence of pulmonary inflammation, aspiration of stomach contents, age at death, sex, and death-postmortem interval. There were, however, lower concentrations of phosphatidylcholine and phosphatidylcholine palmitate content in infants colonised by organisms with reported phospholipase A2 activity.
对46例年龄在3至100周之间的婴儿死亡病例进行了一项前瞻性研究，研究内容包括结构化尸检，随后收集肺灌洗样本用于表面活性物质磷脂分析以及微生物检查样本。在研究的46例婴儿中，23例仅死于婴儿猝死综合征（SIDS）；另有12例的死因是SIDS，但存在其他不足以解释死亡原因的临床或病理表现（“SIDS加”）。11例存在其他死因（“非SIDS”）。死于SIDS的婴儿肺灌洗样本中磷脂酰胆碱浓度显著降低，且磷脂酰胆碱中的棕榈酸含量显著降低。表面活性物质磷脂异常与已知病原体的存在、肺部炎症的组织学证据、胃内容物误吸、死亡年龄、性别以及死亡至尸检间隔时间之间均无关联。然而，具有报告的磷脂酶A2活性的生物体定植的婴儿中，磷脂酰胆碱和磷脂酰胆碱棕榈酸含量较低。
