促红细胞生成素干预早产儿脑损伤机制的研究进展

Research progress in the mechanism of erythropoietin intervention on the brain injury in preterm neonates

早产儿脑损伤可继发多种严重并发症,其严重的神经系统后遗症已成为新的临床、公共卫生和社会问题。目前研究发现促红细胞生成素(erythropoietin,EPO)能减轻早产儿脑损伤,对损伤的脑神经细胞有保护和修复作用,并可能提高远期神经预后。EPO发挥神经保护作用的主要机制是促进早产儿脑血管成熟、缓解血管痉挛,促进血管新生,在缺血部位建立侧枝循环改善脑缺血情况;对缺血缺氧(hypoxic ischemic,HI)后神经元凋亡和炎性坏死的双重阻断作用;抗氧化效果;减少谷氨酸毒性;营养神经及促进神经元的增值、树突增多、功能增强等。EPO对早产儿脑损伤后的多重保护作用为早产儿脑损伤的治疗提供了临床应用前景。

Brain injury of premature infant can be secondary to a variety of serious complications, with the increase of premature birth rate. The severe neurological sequelae has become a new clinical, public health and social problems. It has been found that erythropoietin （EPO） can reduce premature brain damage, protect and repair damaged nerve cells, and improve the long-term prognosis of nervous system. The main mechanism of EPO neuroprotective effect is to promote cerebrovascular maturity, relieve vasospasm, promote angiogenesis and establish collateral circulation to improve cerebral ischemia damage. Other neuroprotective mechanisms include anti-apoptosis, anti-inflammatory and so on. In addition, EPO can also increase proliferation of neurons and enhance neural function. EPO may provide a new approach for promoting survival and growth in nerve cells and hold great promise for the future treatments of premature brain injury.