通讯作者: 彭芬, 814321338@qq.com

DOI：10.12201/bmr.202610.00008

Neuroprotective Therapy for Neonatal Hypoxic-Ischemic Encephalopathy: From Therapeutic Hypothermia to Multi-Target Combination Strategies

• 摘要：新生儿缺氧缺血性脑病是围产期因脑血流灌注和氧供减少导致的严重神经系统病症，全球每年约120万新生儿受累，我国发病率约为3‰～6‰。亚低温治疗是目前唯一询证支持的标准化神经保护策略，可改善中重度患儿远期结局，但仍有约29%患儿预后不良，且其适用人群边界尚存争议。以亚低温为基础联合促红细胞生成素、褪黑素、别嘌呤醇、氢气、氙气、硫酸镁、托吡酯等多靶点药物研究渐增，部分研究显示潜力，但大规模随机对照证据仍较缺乏。干细胞治疗尤其是脐带血细胞输注初显神经修复潜力。鉴于远期功能障碍可累及运动、认知、行为等多维度，构建贯穿学龄期的多学科随访康复体系具有重要临床意义。未来应借助生物标志物实现精准分层，将治疗目标从短期存活拓展至全生命周期功能优化。

  关键词： 新生儿；缺氧缺血性脑病；亚低温治疗；神经保护性药物；干细胞; ; ; ; 

   

  Abstract: Neonatal hypoxic-ischemic encephalopathy (HIE) is a severe neurological disorder caused by reduced cerebral blood perfusion and oxygen supply during the perinatal period. Approximately 1.2 million neonates are affected worldwide each year, and the reported incidence in China is about 3‰–6‰. Therapeutic hypothermia is currently the only internationally recognized standardized neuroprotective therapy that improves long-term outcomes in neonates with moderate-to-severe HIE; however, approximately 29% of treated infants still develop adverse neurodevelopmental outcomes, and the optimal boundaries of its indications remain controversial. In recent years, multi-target strategies combining therapeutic hypothermia with pharmacological agents such as erythropoietin, melatonin, allopurinol, hydrogen, xenon, magnesium sulfate, and topiramate have become a research focus. Although some studies suggest potential benefits, large-scale randomized controlled evidence remains limited. Stem cell therapy, particularly umbilical cord blood cell infusion, has shown preliminary promise in promoting neural repair. Given that long-term dysfunction may involve motor, cognitive, and behavioral domains, establishing a multidisciplinary follow-up and rehabilitation system extending through school age is of considerable clinical importance. Future efforts should aim to achieve precise patient stratification using biomarkers and to expand therapeutic goals from short-term survival to lifelong functional optimization.

  Key words: Neonatal; Hypoxic-ischemic encephalopathy; Therapeutic hypothermia; Neuroprotective agents; Stem cells

  提交时间：2026-10-06

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
• html

• 图表

• 赵婉君, 闫菊. 新生儿缺氧缺血性脑病血清生物标志物研究进展. 2025. doi: 10.12201/bmr.202502.00036

  赵士棋. 多模态监测在新生儿脓毒症相关性脑病的应用. 2025. doi: 10.12201/bmr.202501.00028

  宋康红, 安红伟, 王瑞鑫. LncRNA MALAT1治疗缺血性脑卒中的潜在价值. 2025. doi: 10.12201/bmr.202506.00007

  庄旭颉, 高丽丽. 基于NLRP3信号通路探究中医药靶治疗缺血性脑卒中的研究进展. 2025. doi: 10.12201/bmr.202509.00056

  贾占武, 裴文娟, 唐玉彬, 张艳阳. 外泌体用于缺血性脑卒中治疗的研究进展. 2026. doi: 10.12201/bmr.202603.00118

  莫洁贞, 徐睿霞. 新生儿凝血功能危急值的临床评估与干预现状. 2026. doi: 10.12201/bmr.202606.00061

  李锐, 熊小平, 田小龙. 高压氧治疗急性缺血性卒中早期疗效研究. 2026. doi: 10.12201/bmr.202605.00064

  贺思佳. 胱抑素C与缺血性脑卒中的关系研究进展. 2025. doi: 10.12201/bmr.202511.00036

  张林, 侯艳红, 吴凯, 李炳慧. 胃肠肿瘤免疫微环境多靶点精准分型及临床治疗策略适配性研究. 2026. doi: 10.12201/bmr.202606.00026

  p> 陆崧瀚, 王凯华▲, 覃社焕, 贺思佳, 杨漫椿, 苏桂兰. Klotho蛋白与缺血性脑卒中的关系研究进展. 2026. doi: 10.12201/bmr.202603.00114

• 序号	提交日期	编号	操作
  1	2026-09-04	10.12201/bmr.202610.00008V1	下载

• 公开评论  匿名评论  仅发给作者 提交评论