早产儿晚发性循环衰竭的研究进展

Progress of late-onset circulatory collapse in preterm infants

早产儿晚发性循环衰竭(late-onset circulatory collapse,LCC)的主要特点是早产儿出生1周后突然出现低血压、少尿,且对扩容、血管活性药物治疗无反应,而及时的糖皮质激素治疗则效果显著。发生LCC的早产儿如得不到及时有效的治疗,可能会出现呼吸、消化系统并发症以及神经系统后遗症。目前认为相对性肾上腺皮质功能不全是其主要原因,但具体病理生理机制尚不清楚。该文将对LCC发生的病理生理机制、临床表现、诊断治疗及预后等方面进行综述。

Late-onset circulatory collapse(LCC)in preterm infants is characterized by sudden onset of hypotension and/or oliguria after the first week of life,which is resistant to volume expanders and inotropes but responds rapidly to timely glucocorticoids treatment.LCC should be managed promptly and properly,or it may cause respiratory,digestive complications and life-long neurological problems.Relative adrenal insufficiency is considered the most likely cause of LCC,but its pathophysiology remains unclear.This review summarizes the current reserch about LCC regarding its pathophysiology,clinical features,diagnosis,treatment,and prognosis.