胎儿炎症反应综合征研究进展

胎儿炎症反应综合征(fetal inflammatory response syndrome,FIRS)是胎儿固有免疫系统被激活的一种亚临床状态,是全身炎症反应综合征(systemic inflammation response syndrome,SIRS)在胎儿期的特殊表现。宫内感染及胎儿宫内慢性缺氧是导致FIRS的两个重要原因。感染或缺氧所致的"失控"的全身性炎症反应是FIRS发生的主要机制。FIRS与早产、支气管肺发育不良、新生儿早发型败血症、新生儿脑损伤、新生儿坏死性小肠结肠炎等新生儿严重并发症密切相关。FIRS宫内表现通常不典型,极易忽视,如不及时干预,新生儿期可能出现脑瘫、多器官功能衰竭、死亡等严重后果。本文就近年FIRS的临床诊断、发病机制和危害等方面的研究进展进行综述。

Advances in Fetal Inflammatory Response Syndrome

The fetal inflammatory response syndrome (FIRS) is a subclinical state in which the fetal immune system is activated. It is a special situation of systemic inflammatory response syndrome (SIRS) in the fetal period. Intrauterine infection and chronic hypoxia are two important reasons of FIRS. The "Uncontrolled" systemic inflammatory response due to infection or hypoxia is the main mechanism of FIRS. FIRS is closely related to adverse neonatal outcome such as premature delivery, bronchopulmonary dysplasia, neonatal early-onset sepsis, neonatal brain injury, and neonatal necrotizing enterocolitis. The clinical performance of FIRS is often atypical and easily overlooked, but may result in serious outcomes in the neonatal period, such as cerebral palsy, multiple organ failure, and even death. This article summarizes the research progress in the clinical diagnosis, pathogenesis and adverse neonatal outcome of FIRS in recent years.