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新生儿缺氧缺血性脑损伤(hypoxic-ischemic brain damage,HIBD)是由围生期缺氧所引起的严重疾病,可以导致神经元功能长期丧失,甚至死亡。存活者中一部分患儿会遗留脑瘫、癫痫、精神障碍、认知,感觉及运动障碍等一系列后遗症。然而,目前尚无有效的治疗方式可以保护脑组织在缺氧缺血过程中免受损伤。主要是不能确定缺氧缺血发生的准确时间,且不能准确地识别每一个病人损伤和修复的确切时相点。越来越多的研究用来探讨缺氧缺血性脑损伤及其神经功能障碍的结构机理,以期进一步在新生儿期对该病进行神经靶点保护机制的研究。本文主要从缺氧缺血性脑损伤的神经系统改变和干细胞为基础的再生治疗策略入手,就内源性神经疗法、外源性神经疗法、神经干细胞的临床试验、尚未解决的问题等进行综述。
Hypoxic-ischemic brain damage (HIBD) is a serious disease caused by perinatal hypoxia, which leads to long-term loss of neuronal function and even death. Some survivors will be left with cerebral palsy, epilepsy, mental disorders, cognitive, sensory and motor disorders and a series of sequelae. However, there is no effective treatment to protect the brain tissue from hypoxia and ischemia during the injury. Mainly can not determine the exact time of occurrence of hypoxia and ischemia, and can not accurately identify the exact time of injury and repair of each patient. More and more studies are used to explore the structural mechanism of hypoxic-ischemic brain damage and its neurological dysfunction in order to further study the mechanism of neural target protection during the neonatal period. This review focuses on the changes of the nervous system and stem cell-based regenerative therapy of hypoxic-ischemic brain damage and reviews the clinical research of endogenous neurotrophic therapy, exogenous neurological therapy, neural stem cells, unresolved problems and so on .