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早产儿脑白质损伤的研究进展
随着新生儿医学的发展,早产儿的救治成功率明显提高,而神经系统后遗症的发生率却居高不下.早产儿脑损伤以脑白质损伤(white matter damage,WMD)为主.早产儿少突胶质细胞对损伤的易感性及各种内、外损伤因素共同作用是早产儿WMD的主要原因之一[1].早产儿WMD分为脑室周围白质软化(periventricular leukomalacia,PVL)和弥漫性脑白质损伤(diffuse white matter damage)[2].现就早产儿WMD的病因、发病机制、早期诊断方法及防治策略的研究进展进行综述.
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The Chinese compound Kaixin Jieyu Fang can be used to treat vascular depression;however, the underlying mechanism remains unclear. This study established a rat model of chronic cerebral ischemia-caused white matter damage by ligation of the bilateral common carotid arteries. Rats received daily intragastric administration of a suspension of Kaixin Jieyu Fang powder. After 3, 7 and 21 days of treatment, the degree of white matter damage in the cerebral ischemia rat model was alleviated, Bcl-2 protein and mRNA expression in brain tissue increased, and Bax protein and mRNA expression decreased. These results indicate that Kaixin Jieyu Fang can alleviate cere-bral white matter damage, and the underlying mechanism is associated with regulation of Bcl-2/Bax protein and mRNA expression, which is one of possible mechanism behind the protective effect of Kaixin Jieyu Fang against vascular depression.
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Myelin regeneration is indispensably important for patients suffering from several central nervous system (CNS) disorders such as multiple sclerosis (MS) and spinal cord injury (SCI), because it is not only essential for restoring neurophysiology, but also protects denuded axons for secondary degeneration. Understanding the cellular and molecular mechanisms underlying re-myelination is critical for the development of remyelination-speciifc therapeutic approaches. As remyelination shares certain common mechanisms with developmental myelination, knowledge from study of developmental myelination contributes greatly to emerging myelin regeneration therapies, best evidenced as the recently developed human anti-Nogo receptor interacting pro-tein-1 (LINGO-1) monoclonal antibodies to treat MS patients in clinical trials.
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早产儿脑损伤的诊治进展
早产儿脑损伤可归纳为:出血缺血性脑损伤(hemorrhagic-ischemic cerebral injury)[1],指脑室周围-脑室内出血(peri-intraventricular hemorrhage,PIVH);脑室旁白质损伤(periventricular white matter damage),是早产儿特征性的脑损伤形式,由于此类损伤直接影响小儿远期预后,是神经系统发育异常的重要病因,多年来引起人们广泛关注.
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早产儿脑白质损伤的影像学诊断进展
早产儿脑白质损伤(white matter damage,WMD),指24~35周出生的早产未熟儿由血管损伤和炎症反应而致的大脑白质病变,是早产儿常见的脑损伤形式.19世纪中叶Parrot和Virchow等首先记载了本症,1962年Banker和Larroche又对本症做了详细报道,确定了PVL的概念[1].该病是导致早产儿伤残的重要原因.