围生期脑损伤对出生后神经系统的影响及可能机制

The Effect and Mechanism of Perinatal Brain Damage on Nervous System after Birth

围生期各种原因引起胎儿脑损伤,可导致出生后中枢神经系统特殊病理生理过程及神经病理改变,使出生后学习记忆能力、运动行为能力、视听觉功能及认知能力出现障碍。围生期因素致出生后神经系统发育障碍的相关机制尚不明确,可能与脑组织发生病理生理改变、神经系统受体与受体相关通道调控失衡及脑内细胞因子释放调节受到破坏有关:脑组织细胞数量相应减少、脑白质破坏、海马区质量减轻、细胞内钙超载是脑损伤后脑组织主要病理生理变化,谷氨酸受体NMDA受体、多巴胺受体及糖皮质激素受体在脑内表达有相应变化,体内细胞因子白细胞介素和BDNF的稳态被破坏,同时在出生早期即可表现为血浆神经元特异性烯醇化酶的异常及高表达的S-100蛋白。

Prenatal brain damage is the results of coaction of many factors,which can induce pathological action of central nervous system and neuropathological changes.Those infants and children may have deficiencies or disorders of learning and memory,behavior and movement audio-visual ability and congnition after birth.The mechanism of perinatal brain damage on neurological development after birth is unidentified yet.It could be related to pathophysiologic changes of cerebral tissue,unbalance of receptors and receptor-related channels of nervous system and malajustment of cerebral cytokines：decrease of cerebral cell,injury of cerebral white matter,decrease of the weight of hippocampal area and overload of endocellular calcium,which are the main pathophysilolgic changes of cerebral tissue;the expression of NMDA receptor,dopamine receptor and glucocorticoid receptor may change;cerebral cytokines and BDNF may have unbalanced environment,and abnormal elevated levels of NSE at birth as well as progressive increase of PS-100 could be found in the newborns during the first week of life.