缺氧缺血性脑病的性别差异性研究进展

新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)是指围产期窒息缺氧导致的脑缺氧缺血性损害,可遗留不同程度的神经系统后遗症。动物研究表明,缺氧缺血性损伤后,炎性反应、氧化应激和细胞死亡途径等关键病理生理过程中存在明显的性别差异,雌性动物对亚低温、促红细胞生成素、脑源性营养因子和别嘌呤醇等治疗效果也明显优于雄性。临床研究发现男性HIE患儿病情更重、预后更差。基于性别的治疗干预很有可能在围产期脑损伤中提供更好的神经保护。本文总结了目前HIE性别差异性的相关证据,以期为临床治疗提供新思路。

Advances in gender difference in hypoxic-ischemic encephalopathy

Neonatal hypoxic-ischemic encephalopathy(HIE),a hypoxic-ischemic brain damage caused by perinatal asphyxia and hypoxia,causes varying degrees of neurological sequelae.Animal studies have shown that there are significant gender differences in key pathophysiological processes such as inflammatory response,oxidative stress and cell death pathway after hypoxic-ischemic injury.The therapeutic effect of mild hypothermia,erythropoietin,brain-derived nutritional factor and allopurinol on female animals was also significantly better than males.Clinical studies have found that male patients are more likely to have a more serious condition and worse prognosis.Potentially,gender-based management may provide better neuroprotection in perinatal brain injury.This article reviews the current evidence for the gender difference in neonatal hypoxic-ischemic encephalopathy,and to shed light on current clinical practice.