中国实用儿科杂志

中国实用儿科杂志 ›› 2026, Vol. 41 ›› Issue (1): 30-36.DOI: 10.19538/j.ek2026010607

• 专题笔谈 • 上一篇    下一篇

中、重度缺氧缺血性脑病患儿亚低温神经保护策略及远期评价

  

  1. 四川大学华西第二医院儿科  出生缺陷与相关妇儿疾病教育部重点实验室，四川  成都  610041
  • 出版日期:2026-01-06 发布日期:2026-02-25
  • 通讯作者: 唐军，电子信箱：tj1234753@sina.com
  • 基金资助:
    国家重点研发计划（2024YFC2707705）；四川省自然科学基金项目（2025ZNSFSC0639、2025ZNSFSC1675）；吴阶平医学基金会临床科研专项资助基金（320.6750.2025-9-27）

Neuroprotection strategies and long-term evaluation of therapeutic hypothermia for neonates with moderate to severe hypoxic-ischemic encephalopathy#br#

  1. Department of Pediatrics，West China Second University Hospital，Key Laboratory of Birth Defects and Related Diseases of Women and Children，Sichuan University，Chengdu  610041，China
  • Online:2026-01-06 Published:2026-02-25

摘要： 亚低温治疗是中、重度缺氧缺血性脑病（hypoxic ischemic encephalopathy，HIE）的标准治疗策略，其可通过降低脑组织代谢水平、抑制脑组织炎性反应、减少脑组织细胞凋亡、改善血脑屏障的通透性、减少自由基产生等发挥显著的神经保护作用。目前，单独的亚低温治疗对中、重度HIE患儿的神经保护策略是不足的。探索亚低温联合促红细胞生成素、抗癫痫药、褪黑素、干细胞移植等共同治疗中、重度HIE的神经保护策略至关重要。同时，亚低温治疗可显著降低中、重度HIE患儿的远期病死率和神经系统不良事件发生率。然而，对于出生6 h后或胎龄<35周的早产儿进行亚低温治疗的远期评价有待进一步探索，以期为临床治疗中、重度HIE提供科学参考。

关键词: 中、重度缺氧缺血性脑病, 亚低温治疗, 神经保护, 远期疗效

Abstract: Therapeutic hypothermia is the standard treatment strategy for moderate to severe hypoxic-ischemic encephalopathy（HIE）. It exerts significant neuroprotective effects through multiple mechanisms，including decreasing brain tissue metabolic levels，suppressing neuroinflammation，reducing brain tissue cell apoptosis，improving blood-brain barrier permeability，and reducing the production of free radicals，etc. Currently，therapeutic hypothermia alone is insufficient in neuroprotection strategies for infants with moderate to severe HIE. It is crucial to explore combined neuroprotection strategies of hypothermia along with erythropoietin，antiepileptic drugs，melatonin，and stem cell transplantation for the treatment of moderate to severe HIE. Furthermore，hypothermia therapy can significantly reduce longterm mortality and incidence of neurological adverse events in individuals with moderate to severe HIE. However，the long-term evaluation of hypothermia for neonates beyond 6 hours after birth or preterm infants under 35 weeks of gestation warrants further investigation， which may provide scientific reference for the clinical treatment of moderate to severe HIE.

Key words: moderate to severe hypoxic-ischemic encephalopathy, therapeutic hypothermia, neuroprotection, long-term effect