Banks B D, Beck R W, Columbus M, Gold P M, Kinsinger F S, Lalonde M A
Canadian Memorial Chiropractic College, Toronto, Canada.
J Manipulative Physiol Ther. 1987 Oct;10(5):246-52.
Sudden infant death syndrome is the term applied to the sudden death of an infant or young child that is unexpected by history and for which a thorough postmortem examination fails to demonstrate an adequate cause of death. It is widely believed that sudden infant death syndrome is not an expression of a single cause and effect, but rather a multifactorial phenomenon. This paper gives an overview of recent developments in sudden infant death syndrome research presenting the various hypotheses regarding sudden infant death. Functional disturbances in the brainstem and cervical spinal cord areas related to the neurophysiology of respiration may contribute to the clinical findings associated with sudden infant death syndrome. Parturitional factors, which include maternal (labor and delivery) and extrinsic factors (obstetrical procedures) have received attention. Work has also been done on the development of those neuroanatomical structures associated with respiration. It is postulated that human development progresses through stages with a critical period at 2-4 months. Immaturity of the brainstem and cervical cord is characterized, histologically, by the presence of reticular dendritic spines on the neurons as well as a proliferation of astrocytes and glial cells. Any process, whether genetic, biochemical, biomechanical or traumatic, that alters normal development of the respiratory control centers related to spinal constriction and compression following birth trauma may be contributory to sudden infant death syndrome.
婴儿猝死综合征是指婴儿或幼儿的突然死亡,根据病史无法预料,且全面的尸检未能发现充分的死亡原因。人们普遍认为,婴儿猝死综合征并非单一因果关系的表现,而是一种多因素现象。本文概述了婴儿猝死综合征研究的最新进展,介绍了关于婴儿猝死的各种假说。与呼吸神经生理学相关的脑干和颈脊髓区域的功能紊乱可能导致与婴儿猝死综合征相关的临床表现。分娩因素,包括母体因素(分娩过程)和外在因素(产科操作)已受到关注。关于与呼吸相关的神经解剖结构的发育也开展了研究。据推测,人类发育通过不同阶段进行,关键期在2至4个月。从组织学上看,脑干和颈髓不成熟的特征是神经元上存在网状树突棘以及星形胶质细胞和神经胶质细胞的增殖。任何改变与出生创伤后脊柱收缩和压迫相关的呼吸控制中心正常发育的过程,无论是遗传、生化、生物力学还是创伤性的,都可能导致婴儿猝死综合征。