极早产儿脑室内出血的发病机制

Ol'ga P. Saryeva, Elena V. Protsenko
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摘要

脑室内出血(IVH)是极低和极低体重新生儿最常见的脑损伤类型之一。极早产儿IVH的主要来源是生发基质。脑室管膜下结构,由低分化、随机排列的细胞组成,血管化良好,结缔组织支持差。生发基质是大脑神经元和神经胶质细胞的主要提供者,在大脑区域中具有独特的血管生成速率和发育过程中选择性出血的脆弱性。早产儿IVH的病因和发病机制是高度多因素的,尚未得到充分的研究。本文就早产儿IVH发病机制的要点进行综述。 结论:IVH是一种潜在的破坏性疾病,在阐明脑损伤的原因和机制方面取得了一定的进展。深入了解脑室内出血的发病机制将有助于选择最佳的治疗策略,并开发新的方法来预防和治疗这种病理。
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Pathogenetic Aspects of Intraventricular Hemorrhages in Extremely Premature Infants
INTRODUCTION: Intraventricular hemorrhage (IVH) is one of the most common types of the brain damage in newborns with extremely low and very low body mass. The main source of IVH in the extremely premature infants is the germinal matrix. This is a subependymal structure of the brain consisting of poorly differentiated, randomly arranged cells, well vascularized with vessels with a poor connective-tissue support. The germinal matrix a key supplier of neurons and glial cells of the brain is unique among the brain regions for its specific rate of angiogenesis and selective vulnerability to hemorrhages during its development. Etiology and pathogenesis of IVH in premature infants are highly multifactorial and have not been fully studied. In this review, the data on the key points of the pathogenesis of IVH in premature infants are generalized. CONCLUSION: IVH is a potentially destructive disease, in the study of which a certain progress has been achieved in elucidating the causes and mechanisms of brain damage. In-depth understanding of the key points of the pathogenesis of intraventricular hemorrhage will permit to choose the optimal management tactics and develop new approaches to prevention and treatment of this pathology.
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