Høgåsen A K
Barneklinikken Rikshospitalet, Oslo.
Tidsskr Nor Laegeforen. 1997 Nov 10;117(27):3957-60.
Neonatal sepsis remains a major clinical problem in neonatology, with high morbidity and mortality rates. The host defence against infections is immature in the newborn infant, and this makes the child more susceptible to invasive infection. The neutrophil storage pool and various granulocyte functions are impaired. In addition, the levels of immunoglobulins and complement are low. The detection of raised levels of complement activation products and cytokines may be of diagnostic help at an early stage of neonatal infection. Rapid treatment with antibiotics is essential for a favourable outcome. Possible adjuvant treatment may be to reduce the relative immunodeficiency by giving immunoglobulins or colony-stimulating factors which increase the production of leukocytes. Further, the potent inflammatory reaction initiated by the microorganisms may be suppressed by various therapies. In spite of much research in this field, no such adjuvant treatment has so far been shown to improve the outcome of neonatal sepsis.
新生儿败血症仍然是新生儿学中的一个主要临床问题,发病率和死亡率都很高。新生儿抵御感染的宿主防御机制不成熟,这使得儿童更容易受到侵袭性感染。中性粒细胞储存池和各种粒细胞功能受损。此外,免疫球蛋白和补体水平较低。检测补体激活产物和细胞因子水平升高可能在新生儿感染的早期阶段具有诊断帮助。早期使用抗生素治疗对于获得良好预后至关重要。可能的辅助治疗方法是通过给予免疫球蛋白或集落刺激因子来降低相对免疫缺陷,这些物质可增加白细胞的产生。此外,微生物引发的强烈炎症反应可通过各种疗法加以抑制。尽管在该领域进行了大量研究,但迄今为止尚未证明任何此类辅助治疗能改善新生儿败血症的预后。