Vplyv chorioamnionitídy na morbiditu predčasne narodených novorodencov a možné terapeutické intervencie
Authors:
L. Dočekalová 1; J. Kopincová 2; M. Kolomazník 3; L. Časnocha-Lúčanová 1; K. Maťašová 1
Authors‘ workplace:
Department of Neonatology, University Hospital Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovak Republic
1; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovak Republic
2; Biomedical Center Martin and Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovak Republic
3
Published in:
Čes-slov Pediat 2020; 75 (7): 436-442.
Category:
Review
Overview
Incidencia predčasných pôrodov neustále narastá, pričom stále vyšší počet novorodencov sa zachraňuje v čoraz nižších gestačných týždňoch. Aj napriek výrazným pokrokom v starostlivosti o predčasne narodeného novorodenca, prematurita aj naďalej predstavuje limitujúci faktor pre ďalší vývoj týchto detí, keďže sa spája s veľkou mierou morbidity aj mortality.
Medzi najčastejšie príčiny spôsobujúce predčasný pôrod patrí chorioamnionitída. Jej problém nespočíva len v procesoch, ktoré vedú k predčasnému pôrodu, ale aj v samotnom zápale, ktorý môže spôsobiť výrazné komplikácie a signifikantne zhoršiť prognózu prematúrneho novorodenca. Negatívne účinky pritom nie sú pripísané len samotnému mikroorganizmu, ale hlavne prooxidačným a prozápalovým procesom, ktoré tieto patogény navodzujú. Keďže antibiotická liečba je zameraná len na ich usmrtenie alebo inhibíciu ďalšieho rastu a množenia, cieľom viacerých výskumov je nájsť takú terapeutickú intervenciu, ktorá by potlačila produkciu cytokínov a voľných radikálov. Najviac nádejnými sa zdajú byť melatonín, pentoxyfylín, erytropoetín a N-acetylcysteín. Tieto liečivá môžu zmierniť ničivé účinky oxidačného stresu a zápalu na rôzne orgánové systémy u novorodenca a tak znížiť komplikácie súvisiace s predčasným pôrodom vyvolaným chorioamnionitídou.
Klíčová slova:
chorioamnionitída – predčasne narodený novorodenec – oxidačný stres – zápal – neuroprotekcia
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Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2020 Issue 7
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