褪黑素联合亚低温治疗新生儿缺氧缺血性脑病的研究进展

Research research on the use of melatonin in combination with therapeutic hypothermia for the treatment of neonatal hypoxic-ischemic encephalopathy

摘要:

新生儿缺氧缺血性脑病（hypoxic-ischemic encephalopathy，HIE）是足月儿死亡和远期神经发育障碍的主要病因之一，尚无根治措施。亚低温治疗（therapeutic hypothermia，TH）是新生儿监护病房中HIE的标准疗法，但在偏远地区的安全性和有效性尚不确定。褪黑素（melatonin，MT）是一种主要由松果体分泌的吲哚类内分泌激素，能够轻易穿透血脑屏障。通过受体和非受体机制，MT发挥抗氧化、抗炎效果，参与调控细胞器功能、抑制细胞死亡。可靠的安全性及临床（前）结果使MT被认为是治疗HIE有前景的药物之一。该文就MT联合TH治疗HIE的研究进展进行综述。

Abstract:

Neonatal hypoxic-ischemic encephalopathy (HIE) remains one of the leading causes of death and long-term neurodevelopmental disorders in full-term neonates, and there is currently no curative treatment. Therapeutic hypothermia is now a standard therapy for HIE in the neonatal intensive care unit, but its safety and efficacy in remote areas remains unclear. Melatonin is an indole endocrine hormone mainly produced by the pineal gland and it has the ability to easily penetrate the blood-brain barrier. Through receptor and non-receptor mechanisms, melatonin exerts anti-oxidative and anti-inflammatory effects and participates in the regulation of organelle function and the inhibition of cell death. Melatonin is considered one of the most promising drugs for the treatment of HIE based on its reliable safety profile and clinical/preclinical results. This article reviews the recent research on the use of melatonin in combination with therapeutic hypothermia for the treatment of neonatal HIE.