Newborn Brain Research Institute, University of California, San Francisco, California, USA.
Semin Fetal Neonatal Med. 2010 Oct;15(5):293-8. doi: 10.1016/j.siny.2010.02.002. Epub 2010 Mar 7.
Neuroprotection is a major health care priority, given the enormous burden of human suffering and financial cost caused by perinatal brain damage. With the advent of hypothermia as therapy for term hypoxic-ischemic encephalopathy, there is hope for repair and protection of the brain after a profound neonatal insult. However, it is clear from the published clinical trials and animal studies that hypothermia alone will not provide complete protection or stimulate the repair that is necessary for normal neurodevelopmental outcome. This review critically discusses drugs used to treat seizures after hypoxia-ischemia in the neonate with attention to evidence of possible synergies for therapy. In addition, other agents such as xenon, N-acetylcysteine, erythropoietin, melatonin and cannabinoids are discussed as future potential therapeutic agents that might augment protection from hypothermia. Finally, compounds that might damage the developing brain or counteract the neuroprotective effects of hypothermia are discussed.
神经保护是一项主要的医疗保健重点，因为围产期脑损伤给人类带来了巨大的痛苦和经济负担。随着低温作为治疗足月缺氧缺血性脑病的方法的出现，人们希望在新生儿严重损伤后能够修复和保护大脑。然而，从已发表的临床试验和动物研究中可以清楚地看出，单纯的低温治疗不会提供完全的保护，也不会刺激修复，而修复对于正常的神经发育结局是必要的。本综述批判性地讨论了用于治疗新生儿缺氧缺血后癫痫发作的药物，并注意了治疗协同作用的可能证据。此外，还讨论了氙气、N-乙酰半胱氨酸、促红细胞生成素、褪黑素和大麻素等其他药物，作为可能增强低温保护作用的未来潜在治疗药物。最后，还讨论了可能损害发育中大脑或抵消低温神经保护作用的化合物。
