Sameshima Hiroshi, Ikenoue Tsuyomu
Department of Obstetrics and Gynecology and Center for Perinatal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kiyotake, Kihara, Miyazaki 889-1692, Japan.
Stroke Res Treat. 2013;2013:659374. doi: 10.1155/2013/659374. Epub 2013 Feb 27.
Hypoxic-ischemic neonatal encephalopathy and ensuing brain damage is still an important problem in modern perinatal medicine. In this paper, we would like to share some of the results of our recent studies on neuroprotective therapies in animal experiments, as well as some literature reviews. From the basic animal studies, we have now obtained some possible candidates for therapeutic measures against hypoxic-ischemic neonatal encephalopathy. For example, they are hypothermia, rehabilitation, free radical scavenger, neurotrophic factors and growth factors, steroid, calcium channel blocker, vagal stimulation, some anti apoptotic agents, pre- and post conditioning, antioxidants, cell therapy with stem cells, modulators of K(+)-ATP channels, and so on. Whether combination of these therapies may be more beneficial than any single therapy needs to be clarified. Hypoxia-ischemia is a complicated condition, in which the cause, severity, and time-course are different in each case. Likewise, each fetus has its own inherent potentials such as adaptation, preconditioning-tolerance, and intolerance. Therefore, further extensive studies are required to establish an individualized strategy for neuroprotection against perinatal hypoxic-ischemic insult.
新生儿缺氧缺血性脑病及随之而来的脑损伤仍是现代围产医学中的一个重要问题。在本文中，我们希望分享一些我们近期在动物实验中关于神经保护疗法的研究结果，以及一些文献综述。从基础动物研究中，我们现已获得一些针对新生儿缺氧缺血性脑病的可能治疗措施候选方案。例如，它们是低温疗法、康复治疗、自由基清除剂、神经营养因子和生长因子、类固醇、钙通道阻滞剂、迷走神经刺激、一些抗凋亡药物、预处理和后处理、抗氧化剂、干细胞细胞治疗、K(+)-ATP通道调节剂等等。这些疗法联合使用是否比单一疗法更有益尚需明确。缺氧缺血是一种复杂的情况，其病因、严重程度和病程在每个病例中都有所不同。同样，每个胎儿都有其自身的内在潜能，如适应能力、预处理耐受性和不耐受性。因此，需要进一步广泛研究以制定针对围产期缺氧缺血性损伤的个体化神经保护策略。
