胎儿炎症反应综合征

Fetal inflammatory response syndrome

胎儿炎症反应综合征是胎儿体内先天免疫系统被激活的一种状态，为生后72h的新生儿炎症，其定义为以下几项中〉2项：（1）呼吸过快（〉60次／min），伴有呼吸困难或氧饱和度下降；（2）体温不稳（〉37．9℃或〈36℃）；（3）毛细血管充盈时间〉3S；（4）白细胞计数〉34×10^9／L或〈4×10^9／L；（5）CRP〉10mg／L；（6）IL-6或IL-8〉70g／ml；（7）16SrRNA基因PCR检测阳性。胎儿炎症反应综合征可由感染和非感染因素诱发，显著的特点就是针对外来的侵害胎儿免疫系统过度激活，导致炎症介质、细胞因子的失控性释放，多种炎症介质、细胞因子直接或间接激活凝血系统及干扰机体的抗凝系统，致凝血机制失常，多个系统参与的炎症反应贯穿这一过程。胎儿炎症反应综合征能导致早产、围生儿死亡、脑白质损伤、坏死性小肠结肠炎、影响胎肺的成熟及多器官的损害，为减少胎儿的损伤，对胎儿炎症反应综合征的恰当处理和预测是必要的。

The fetal inflammatory response syndrome （FIRS） is a state of activation of the innate im- mune system in the fetus body and is a kind of neonatal inflammation for 72 hours after birth. It is defined as the following items 〉 2 ： （ 1 ） breathing too fast （ 〉 60 times/rain）, accompanied by breathing difficulties or with oxygen desaturation; （2） temperature instability 〉 37. 9℃ or 〈 36 ℃ ; （ 3 ） capillary filling time 〉 3 s ; （4） the white blood cell count 〉34 ×10^9/L,or 〈4 ×10^9/L; （5） CRP 〉 10 mg/L; （6） IL-6 or IL-8 〉70 g/ml; （7） gene testing of 16S rRNA for PCR is positive. FIRS can be induced by infectious and non-infectious factors. In FIRS,fetal immune system is over-activated to the external violation,which causes uncontrolled release of inflammatory mediators and cytokines. A variety of inflammatory mediators and cytokines directly or indirectly acti- vate the coagulation system and interfere with the body＇s anticoagulation system, which induces the coagulation disorders. Multiple organ systems involved in the inflammatory response throughout this process. FIRS can lead to premature delivery,perinatal death, cerebral white matter damage, necrotizing enterocolitis, and affect fetal lung maturity and multi-organ damage. In order to reduce fetal injury ,it is necessary for appropriate treatment and pre- diction of the FIRS.