Neonatal Netw. 2021 Nov 1;40(6):406-413. doi: 10.1891/11-T-755.
Hypoxic-ischemic encephalopathy (HIE) remains a significant source of long-term neurodevelopmental impairment despite overall improvements in survival without disability in neonates who undergo therapeutic hypothermia. Each phase in the evolution of hypoxic-ischemic injury presents potential pharmacologic targets for neuroprotective agents. Melatonin is a promising emerging therapy for early phases of ischemic injury, but utility is currently limited by the lack of pharmaceutical-grade products. Magnesium has been extensively studied for its neuroprotective effects in the preterm population. Studies in neonates with HIE have produced mixed outcomes. Erythropoietin use in HIE with or without therapeutic hypothermia appears to be safe and may provide additional benefit. Dexmedetomidine, N-acetylcysteine, xenon, and topiramate all have promising animal data, but need additional human trials to elucidate what role they may play in HIE. Frequent review of existing literature is required to ensure provision of evidence-based pharmacologic agents for neuroprotection following HIE.
缺氧缺血性脑病（HIE）仍然是一个重大的长期神经发育障碍的来源，尽管接受治疗性低温的新生儿的总体存活率和无残疾率有所提高。缺氧缺血性损伤的每个阶段都为神经保护剂提供了潜在的药物靶点。褪黑素是一种有前途的缺血性损伤早期治疗方法，但由于缺乏药物级产品，其应用目前受到限制。镁在早产儿中的神经保护作用已得到广泛研究。在 HIE 新生儿中的研究结果喜忧参半。HIE 患者在使用或不使用治疗性低温的情况下使用促红细胞生成素似乎是安全的，并且可能会带来额外的益处。右美托咪定、N-乙酰半胱氨酸、氙气和托吡酯在动物研究中均有良好的效果，但需要进一步的人体试验来阐明它们在 HIE 中的作用。需要经常审查现有文献，以确保为 HIE 后提供基于证据的神经保护药物。
