重组人类促红细胞生成素干预早产儿缺氧缺血性脑损伤机制的研究进展  

Research Progress on the Mechanism of Recombinant Human Erythropoietin Intervention in Hypoxic-Ischemic Brain Injury in Premature Infants

作　　者：孙正达 宋启君 王立俊 

机构地区：[1]山东第一医科大学研究生院,山东 济南 [2]山东第一医科大学附属济南市妇幼保健院,山东 济南 [3]山东第一医科大学附属省立医院儿科,山东 济南

出　　处：《临床医学进展》2023年第7期10974-10981,共8页Advances in Clinical Medicine

摘　　要：早产儿获得性脑损伤,特别是缺氧缺血性脑损伤(hypotic-ischemic brain damage, HIBD)的发生率和致残率呈上升趋势。脑白质损伤是HIBD中最常见的类型之一,可导致早产儿出现痉挛双瘫、视觉缺陷、认知障碍、脑瘫和行为缺陷等神经系统后遗症,其中最为常见的是脑室周围白质软化(Pvriventricular Leuko-malacia, PVL)。随着国内二胎三胎政策的放开,早产儿或极低出生体重儿占比率逐渐增多,而目前在新生儿重症监护病房只有有限的治疗方法可以改善HIBD的预后,比如亚低温疗法。目前研究发现在早产儿的治疗中给予重组人促红细胞生成素(recombinant human eryth-ropoientin, rhEPO)干预可改善其神经发育结果,然而早产儿脑损伤后应用rhEPO的神经保护作用的潜在机制尚不完全清楚。本文章综述了通过目前大量细胞生物学和动物实验以及临床试验的研究结果,来判断rhEPO是否可以用于治疗早产儿脑损伤并评估其疗效以及应用rhEPO的安全性。The incidence and disability rate of acquired brain damage in premature infants, especially hypox-ic-ischemic brain damage (HIBD), are on the rise. White matter injury is one of the most common types of HIBD, which can lead to neurological sequelae such as spastic diplegia, visual impairment, cognitive impairment, cerebral palsy, and behavioral impairment in premature infants. The most common type is periventricular leukomalacia (PVL). With the relaxation of the two-child and three-child policy in China, the proportion of premature or extremely low birth weight infants is gradually increasing. Currently, there are only limited treatment methods in the neonatal intensive care unit that can improve the prognosis of HIBD, such as mild hypothermia therapy. At present, research has found that intervention with recombinant human erythropoietin (rhEPO) in the treatment of premature infants can improve their neurodevelopmental outcomes. However, the potential mechanism of the neuroprotective effect of rhEPO after brain injury in premature infants is not fully understood. This article reviews the research results of a large number of cell biology, animal experiments, and clinical trials to determine whether rhEPO can be used to treat brain in-jury in premature infants, evaluate its efficacy, and evaluate the safety of using rhEPO.

关 键 词：重组人促红素(rhEPO) 早产儿 缺氧缺血性脑损伤 神经发育 神经保护 

分 类 号：R72[医药卫生—儿科]