Vplyv chorioamnionitídy na morbiditu predčasne narodených novorodencov a možné terapeutické intervencie

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Autori: L. Dočekalová ¹; J. Kopincová ²; M. Kolomazník ³; L. Časnocha-Lúčanová ¹; K. Maťašová ¹
Pôsobisko autorov: 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
Vyšlo v časopise: Čes-slov Pediat 2020; 75 (7): 436-442.
Kategória: Přehledový článek

Súhrn

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

Zdroje

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