Current and Emerging Therapies in the Management of Hypoxic Ischemic Encephalopathy in Neonates.
Current and Emerging Therapies in the Management of Hypoxic Ischemic Encephalopathy in Neonates.
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新生儿缺氧缺血性脑病的管理和新兴疗法。
DOI：
10.3390/children5070099
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发表时间：
2018-07-19
期刊：
影响因子：
--
通讯作者：
Kumar VHS
中科院分区：
文献类型：
--
作者：
Nair J;Kumar VHS
新生儿缺氧缺血性脑病（HIE）是一个严重的临床问题，其发病率和死亡率在全球范围内都很高。治疗性低温（TH）现在是中重度HIE婴儿的标准治疗，但并没有明确改变重度HIE的结局。在这篇综述中，我们讨论了新的有前途的标志物，可能有助于临床医生确定缺氧缺血性脑病的严重程度。描述了有益的疗法和有望用于神经保护的药剂，无论是单独使用还是作为TH的替代品。这些包括内源性通路调节剂，如促红细胞生成素及其类似物、褪黑激素和远程缺血后处理。干细胞在这种情况下具有治疗潜力，就像在许多其他新生儿疾病中一样。在列出的药物中，目前只有促红细胞生成素及其类似物正在大型随机对照试验（RCT）中进行评估。外源性治疗，如氩和氙，别嘌呤醇，单唾液酸神经节苷脂，硫酸镁继续研究。对脑损伤三级机制的认识开辟了新的治疗研究，不仅可以减轻脑损伤，还可以促进围产期损伤后发育紊乱的大脑中的细胞修复和再生。这些替代方式在轻度HIE和世界上昂贵的低温设备和服务有限的地区可能特别重要。
Neonatal hypoxic ischemic encephalopathy (HIE) presents a significant clinical burden with its high mortality and morbidity rates globally. Therapeutic hypothermia (TH) is now standard of care for infants with moderate to severe HIE, but has not definitively changed outcomes in severe HIE. In this review, we discuss newer promising markers that may help the clinician identify severity of HIE. Therapies that are beneficial and agents that hold promise for neuroprotection are described, both for use either alone or as adjuncts to TH. These include endogenous pathway modifiers such as erythropoietin and analogues, melatonin, and remote ischemic post conditioning. Stem cells have therapeutic potential in this condition, as in many other neonatal conditions. Of the agents listed, only erythropoietin and analogues are currently being evaluated in large randomized controlled trials (RCTs). Exogenous therapies such as argon and xenon, allopurinol, monosialogangliosides, and magnesium sulfate continue to be investigated. The recognition of tertiary mechanisms of brain damage has opened up new research into therapies not only to attenuate brain damage but also to promote cell repair and regeneration in a developmentally disorganized brain long after the perinatal insult. These alternative modalities may be especially important in mild HIE and in areas of the world where there is limited access to expensive hypothermia equipment and services.
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达贝泊汀对因脑病而接受降温的新生儿进行给药：一项安全性和药代动力学试验。
影响因子：
3.6
作者：
Baserga MC;Beachy JC;Roberts JK;Ward RM;DiGeronimo RJ;Walsh WF;Ohls RK;Anderson J;Mayock DE;Juul SE;Christensen RD;Loertscher MC;Stockmann C;Sherwin CM;Spigarelli MG;Yoder BA
通讯作者：
Yoder BA
影响因子：
4.7
作者：
Destot-Wong, Kim-Da;Liang, Kun;Gressens, Pierre
通讯作者：
Gressens, Pierre
影响因子：
3.6
作者：
Alvarez, Francisco J.;Lafuente, Hector;Martinez-Orgado, Jose
通讯作者：
Martinez-Orgado, Jose
影响因子：
3.2
作者：
Baillieul, S.;Chacaroun, S.;Verges, S.
通讯作者：
Verges, S.
DOI：
10.1007/bf02815133
发表时间：
1998-05-01
期刊：
MOLECULAR AND CHEMICAL NEUROPATHOLOGY
影响因子：
--
作者：
Ballough, GPH;Cann, FJ;Filbert, MG
通讯作者：
Filbert, MG