Gancia Paolo, Delogu Antonio, Pomero Giulia
Terapia Intensiva Neonatale-Neonatologia, ASO S. Croce e Carle, Cuneo, Italy.
Terapia Intensiva Neonatale-Neonatologia, ASO S. Croce e Carle, Cuneo, Italy.
Early Hum Dev. 2014 Mar;90 Suppl 1:S39-41. doi: 10.1016/S0378-3782(14)70013-1.
Advances in neonatal intensive care have greatly improved survival rates for children born in a very early stage of lung development (i.e. less than 26 weeks of gestation). In these premature babies, even low levels of oxygen and methods of minimally invasive ventilation may disrupt the growth of the distal airways, a condition described as "new" bronchopulmonary dysplasia (BPD). Ureaplasma infection can occur in utero or in the perinatal period in premature infants, in some of which the infection with these organisms triggers an important lung pro-inflammatory and pro-fibrotic response, and may increase the risk of developing BPD. The inflammation may be worsened by exposure to oxygen and mechanical ventilation. At present, clinical studies have not clarified the role of Ureaplasma in the pathogenesis of BPD and there is insufficient evidence to determine whether antibiotic treatment of Ureaplasma has influence on the development of BPD and its comorbidities. Future research in the context of well-designed and controlled clinical trials of adequate statistical power should focus on how to determine whether the treatment of Ureaplasma decreases lung inflammation, reduces rates of BPD, and improves long-term neurodevelopment.
新生儿重症监护的进展极大地提高了肺发育处于极早期（即妊娠少于26周）出生儿童的存活率。在这些早产儿中，即使是低水平的氧气和微创通气方法也可能扰乱远端气道的生长，这种情况被称为“新型”支气管肺发育不良（BPD）。脲原体感染可发生在早产儿的子宫内或围产期，其中一些感染这些微生物会引发重要的肺部促炎和促纤维化反应，并可能增加患BPD的风险。暴露于氧气和机械通气可能会使炎症恶化。目前，临床研究尚未阐明脲原体在BPD发病机制中的作用，也没有足够的证据来确定针对脲原体的抗生素治疗是否会影响BPD及其合并症的发展。未来在具有足够统计学效力的精心设计和对照的临床试验背景下的研究应侧重于如何确定脲原体治疗是否能减轻肺部炎症、降低BPD发生率并改善长期神经发育。
