早产儿脑损伤：破坏性和发育性障碍的复杂混合体。
Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances.
作者信息
Volpe Joseph J
机构信息
Department of Neurology, Children's Hospital and Harvard Medical School, Boston, MA 02115, USA.
出版信息
Lancet Neurol. 2009 Jan;8(1):110-24. doi: 10.1016/S1474-4422(08)70294-1.
Abstract
Brain injury in premature infants is of enormous public health importance because of the large number of such infants who survive with serious neurodevelopmental disability, including major cognitive deficits and motor disability. This type of brain injury is generally thought to consist primarily of periventricular leukomalacia (PVL), a distinctive form of cerebral white matter injury. Important new work shows that PVL is frequently accompanied by neuronal/axonal disease, affecting the cerebral white matter, thalamus, basal ganglia, cerebral cortex, brain stem, and cerebellum. This constellation of PVL and neuronal/axonal disease is sufficiently distinctive to be termed "encephalopathy of prematurity". The thesis of this Review is that the encephalopathy of prematurity is a complex amalgam of primary destructive disease and secondary maturational and trophic disturbances. This Review integrates the fascinating confluence of new insights into both brain injury and brain development during the human premature period.
摘要
早产儿脑损伤具有重大的公共卫生意义，因为大量此类婴儿存活下来后伴有严重的神经发育障碍，包括严重的认知缺陷和运动障碍。这种类型的脑损伤通常被认为主要由脑室周围白质软化（PVL）构成，这是一种独特的脑白质损伤形式。重要的新研究表明，PVL常伴有神经元/轴突疾病，影响脑白质、丘脑、基底神经节、大脑皮层、脑干和小脑。PVL与神经元/轴突疾病的这种组合足够独特，可被称为“早产儿脑病”。本综述的论点是，早产儿脑病是原发性破坏性疾病与继发性成熟和营养障碍的复杂混合。本综述整合了对人类早产期脑损伤和脑发育的新见解的迷人融合。
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