新生儿坏死性小肠结肠炎相关脑损伤的机制

The mechanism of necrotizing enterocolitis-associated brain injury in neonates

坏死性小肠结肠炎(necrotizing enterocolitis,NEC)是新生儿期一种严重的胃肠道疾病,也是早产儿的主要死亡原因之一。近年来,随着新生儿重症救治水平的提升,NEC患儿生存率也随之提高,但存活者常伴有不良的神经预后,临床可表现为脑室周围白质软化(periventricular leukomalacia,PVL)、脑室内出血(intraventricular hemorrhage,IVH)、神经发育障碍(neurodevelopmental impairment,NDI)等一系列疾病,其确切发病机制目前尚不清楚。该文就NEC相关脑损伤的可能影响因素,如缺氧缺血、炎症反应、营养、脑-肠轴等进行综述,以便于临床医生了解其发病机制。

Necrotizing enterocolitis(NEC)is a serious gastrointestinal disease in the neonatal period and one of the main causes of death in premature infants.In recent years,with the advancement of neonatal intensive care,the survival rate of children with NEC has been improved.However,the survivors are often accompanied by poor neurological prognoses,such as periventricular leukomalacia,intraventricular hemorrhage,neurodevelopmental disorders.The pathogenesis of NEC has not been fully elucidated.This review discusses the factors that may influence NEC related brain injury,such as hypoxia and ischemia,inflammatory response,nutrition,and brain-gut axis,in order to provide an overview on the pathogenesis of NEC.