早产儿脑病的研究现状

Progress in encephalopathy of prematurity

摘要:

近年来，国内外早产发生率呈不断增加的趋势。由于新生儿救治水平的提高，早产儿的存活率也在显著提高，然而幸存的早产儿容易发生脑损伤，已经成为一个严重的公共健康问题。围产期缺氧缺血、感染/炎症是早产儿脑病发生的重要因素，造成少突胶质前体细胞与皮层等处神经元的损伤。脑室周围白质的弥漫性损伤与神经元/轴突的破坏是当前早产儿脑病的重要特点，导致认知、行为障碍、脑瘫等后遗症。近年来，影像学特别是磁共振在临床诊断及随访早产儿脑病中起非常重要作用。本文总结了早产儿脑病的特点及诊断方式，以期为早产儿脑病的临床防治策略提供新的方向。

Abstract:

The preterm birth has been increasing for the last decade. With the development of neonatal intensive care techniques, the survival rate of preterm infants is increased markedly. However, the brain of preterm infants is so vulnerable to injury that preterm brain injury has become an enormous public health problem. Hypoxia-ischemia and infection/inflammation are two main perinatal risk factors causing premyelinating oligodendrocyte and cortical neuron injury. Encephalopathy of prematurity is characterized by diffuse white matter injury and neuronal/axonal disruption, leading to neurological disabilities such as cognitive impairment and cerebral palsy. The advancement in imaging techniques, especially magnetic resonance imaging, provides more information for preterm brain injury and brain development, which contributes to the diagnosis and follow-up of the preterm infants. This article reviews the progress in encephalopathy of prematurity in order to open a new window to prophylaxis and management of this disease.