Department of Neonatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Early Hum Dev. 2010 Mar;86(3):155-8. doi: 10.1016/j.earlhumdev.2010.01.029. Epub 2010 Mar 9.
The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral haemodynamics' includes cerebral blood flow (CBF), cerebral blood flow velocity, and cerebral blood volume (CBV). Therapy aimed at changing vascular anatomy is not available. Therefore, prevention of disturbances in CBF and CBV is pivotal. However, continuous monitoring of CBF and CBV is still unavailable for clinical use. Tissue oxygenation may be used as a surrogate for CBF, although precision is still questionable. General knowledge of the regulation of CBF and CBV is important. Although this knowledge is still incomplete, especially regarding autoregulation and the exact role of CBV, it is still useful. Using it even without knowing the exact level of CBF and CBV, it is possible to aim to keep CBF and CBV stable. Future research should focus on development of monitoring tools, gaining more insight in neonatal cerebral autoregulation, and demonstrating clinical benefits of a 'cerebral perfusion-oriented' therapy.
新生儿，尤其是早产儿，最重要的脑血管损伤是脑出血和缺血性损伤。典型的脑血管解剖结构和脑血流动力学紊乱在病理生理学中起着重要作用。“脑血流动力学”一词包括脑血流量（CBF）、脑血流速度和脑血容量（CBV）。改变血管解剖结构的治疗方法不可用。因此，预防 CBF 和 CBV 的紊乱至关重要。然而，连续监测 CBF 和 CBV 尚未临床应用。组织氧合可用作 CBF 的替代物，尽管其精确性仍存在疑问。了解 CBF 和 CBV 的调节机制非常重要。尽管这方面的知识仍然不完整，尤其是关于自动调节和 CBV 的确切作用，但仍然很有用。即使不知道 CBF 和 CBV 的准确水平，也可以通过维持 CBF 和 CBV 的稳定来达到目的。未来的研究应集中于开发监测工具，深入了解新生儿脑自动调节，并证明“脑灌注导向”治疗的临床益处。
