Berger Hester Rijkje, Brekke Eva, Widerøe Marius, Morken Tora S
Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Dev Neurosci. 2017;39(1-4):36-48. doi: 10.1159/000472709. Epub 2017 Apr 28.
Perinatal hypoxic-ischemic brain injury is a major health problem. Adjuvant treatments that improve the neuroprotective effect of the current treatment, therapeutic hypothermia, are urgently needed. The growing knowledge about the complex pathophysiology of hypoxia-ischemia (HI) has led to the discovery of several important targets for neuroprotection. Early interventions should focus on the preservation of energy metabolism, the reduction of glutamate excitotoxicity and oxidative stress, the maintenance of calcium homeostasis, and the prevention of apoptosis. Delayed interventions should promote injury repair. The multiple metabolic changes following HI as well as the metabolic effects of potential treatments can be observed noninvasively by magnetic resonance spectroscopy (MRS). This mini-review provides an overview of the neuroprotective pharmacological agents that have been evaluated with 1H/31P/13C MRS. A better understanding of how these agents influence cerebral metabolism and the use of relevant translational MRS biomarkers can guide future clinical trials.
围产期缺氧缺血性脑损伤是一个重大的健康问题。迫切需要能提高当前治疗方法（治疗性低温）神经保护作用的辅助治疗。对缺氧缺血（HI）复杂病理生理学认识的不断增加，已促使人们发现了几个重要的神经保护靶点。早期干预应侧重于维持能量代谢、减少谷氨酸兴奋性毒性和氧化应激、维持钙稳态以及预防细胞凋亡。延迟干预则应促进损伤修复。HI后多种代谢变化以及潜在治疗的代谢效应可通过磁共振波谱（MRS）进行无创观察。本综述概述了已通过1H/31P/13C MRS评估的神经保护药物。更好地了解这些药物如何影响脑代谢以及使用相关的转化MRS生物标志物可指导未来的临床试验。
