新生儿缺氧缺血性脑病的发病机制及诊治研究进展

Research Advances in Pathogenesis,Diagnosis and Treatment of Neonatal Hypoxic-Ischemic Encephalopathy

新生儿缺氧缺血性脑病(HIE)是由新生儿大脑血液和氧气供应中断引起,是新生儿死亡和发生永久性神经系统后遗症的主要原因。HIE的发病机制复杂,是一个多环节、多因素的病理生理过程,主要涉及神经系统兴奋毒性、炎症和氧化应激等的相互作用,最终导致急性乃至长期的脑损伤和脑功能损害。亚低温治疗是目前国内外临床公认的治疗HIE的主要方法,但疗效有限。而药物联合亚低温治疗新生儿HIE可以减轻缺氧缺血性脑损伤的程度,促进脑损伤的康复,改善患儿的临床症状,并为未来HIE的相关研究提供新思路。

Hypoxic-ischemic encephalopathy(HIE),which is caused by a disruption in blood and oxygen supply to the brain,is a leading cause of neonatal death and permanent neurological sequelae.The pathogenesis of HIE is complex,and it is a multi-link and multi-factor pathophysiological process,mainly involving the complex interactions of excitotoxicity,inflammation and oxidative stress,which eventually leads to acute and even long-term brain injury and brain function impairment.Therapeutic mild hypothermia is the main method for the treatment of HIE that has been recognized clinically at home and abroad,but the efficacy is limited.Treatment of neonatal HIE with drugs combined with therapeutic mild hypothermia can reduce the degree of hypoxic ischemic brain injury,promote the rehabilitation,and improve the clinical symptoms,and provide a certain direction for the future research on HIE.