早产儿脑室周围白质软化的发病机制研究进展

Advance in Pathogenesis of Periventricular Leukomalacia for Premature Infants (review)

脑室周围白质软化(PVL)是早产儿脑损伤的主要形式,也是早产儿脑性瘫痪和智力障碍的首要原因。患有这些神经系统疾病的低出生体重儿数量不断增加。PVL的启动因素是局部缺血和炎症反应,缺氧缺血和炎症启动兴奋性神经递质和自由基的相互作用,损伤易感的少突神经胶质细胞前体,引起PVL改变,导致脑性瘫痪。因此,预防PVL的发生与发展是降低早产儿脑瘫发病率的关键。而阻断这种机制能够阻止或改善PVL,从而减少或减轻早产儿脑性瘫痪。

Periventricular leukomalacia （PVL） is the predominant form of brain injury and the main cause of cerebral palsy and cogni- tive deficits in premature infants. The number of low-birth-weight infants, who survive to demonstrate these neurologic deficits, is increas- ing. The factors of PVL are ischemia and inflammatory reaction which cause interaction of glutamate and free radicals. Pre-oligodendroglia is highly vulnerable to death caused by their interaction leading to neuropathologic hallmarks of PVL, and resulting in cerebral palsy. It is suggested that the preservation of occurrence and development of PVL is the key for depressing incidence rate of cerebral palsy. Pharmaco- logic interventions that target these toxic molecules will be useful in diminishing the severity of PVL accordingly to decreasing or lessening cerebral palsy in premature infants.