新生儿缺氧缺血性脑病治疗研究进展

Research progress of treatment for neonatal hypoxic ischemic encephalopathy

缺氧缺血性脑病(HIE)是世界范围内新生儿发病和死亡的重要原因之一,其在临床上出现一系列脑病的表现,存活者往往留有神经发育障碍。除了支持对症等综合治疗措施,亚低温是目前已知新生儿HIE的神经保护和改善预后最安全有效的治疗方法。但亚低温并不能提供完全的神经保护,且受胎龄、时间、设施等限制,故临床医师及研究者积极寻找HIE的补充和/或替代疗法。干细胞移植已被提出在HIE治疗中具有良好的应用前景,而促红细胞生成素、氙气、褪黑素等也可能在HIE中发挥重要的神经保护作用。现就新生儿HIE治疗的研究进展进行综述,旨在为临床实践提供理论依据。

Hypoxic ischemic encephalopathy(HIE)is one of the leading causes of neonatal morbidity and mortality worldwide,and it has a series of clinical manifestations of encephalopathy.Survivors often have different degrees of neurodevelopmental impairment.In addition to supporting symptomatic treatment,hypothermia is the safest and most effective treatment for the neuroprotection and the improvement of the prognosis of neonatal HIE.However,hypothermia cannot provide complete neuroprotection and is limited by gestational age,time,and facilities and so on.Therefore,clinicians and researchers actively seek for supplements and/or alternative therapies for neonatal HIE.It was reported that stem cell transplantation has a good application prospect in the treatment of HIE.Erythropoietin and xenon and melatonin may also play neuroprotective roles in HIE.In order to provide a better theoretical basis for clinical practices,this paper reviewed the research progress of neonatal HIE treatment.