早产儿脑损伤生物标志物的研究进展

Research advances in the biomarkers of brain damage in preterm infants

随着围产及新生儿监护技术的不断发展,早产儿的生存率不断提高,与此同时早产儿脑损伤的发生率也在逐渐上升,常遗留不同程度的认知障碍与运动障碍.脑损伤生物标志物检测是诊断脑损伤的重要手段,根据损伤细胞的性质不同可分为神经胶质细胞损伤标志物、神经元损伤标志物及其他生物标志物等几大类,而其中较为成熟并广泛应用于临床的有S100B蛋白、髓鞘碱性蛋白、神经元特异性烯醇化酶等生物标志物.最新研究发现胶质纤维酸性蛋白、神经丝轻链蛋白、α-Ⅱ血影蛋白裂解产物、趋化因子、褪黑素及尿液代谢组学等指标可提示早产儿潜在脑损伤,检测这些生物标志物有助于早产儿脑损伤的早期诊断及早期治疗,对改善其神经发育预后至关重要.该文就早产儿脑损伤生物标志物的最新研究进展作一综述,以期为早产儿脑损伤的早期诊断及早期治疗提供有效依据.

While the survival rate of preterm infants has continually increased with the development of perinatal and neonatal monitoring techniques,the incidence of brain injury in preterm infants has been increasing,resulting in varying degrees of cognitive impairment and movement disorders.Measuring the biomarkers of brain damage is an important means to diagnose brain injury.The biomarkers can be divided into neuroglial damage markers,neuronal damage markers and other markers according to the features of injured cells.The biomarkers widely used in clinical practice include SIOOB protein,myelin basic protein and neuron-specific enolase.Recent studies have newly discovered a collection of markers that can suggest potential brain injury in preterm infants,such as glial fibrillary acidic protein,neurofilament light chain protein,a-II spectrin breakdown products,chemokines,melatonin and urinary metabolomics.These biomarkers can contribute to the early diagnosis and treatment of preterm brain injury,essential for improving neural development and prognosis.This article reviews the latest research advances in the biomarkers of preterm brain injury,in order to provide evidence for the early diagnosis and treatment of this condition.