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中华妇幼临床医学杂志(电子版) ›› 2026, Vol. 22 ›› Issue (01) : 83 -88. doi: 10.3877/cma.j.issn.1673-5250.2026.01.012

综述

早产儿脑白质损伤的发病机制及治疗研究进展
杜文佳1, 李晋辉1,2,()   
  1. 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,成都 610041
    2四川大学华西第二医院天府医院/四川省儿童医院(四川省儿童医学中心)儿科,眉山 620010
  • 收稿日期:2025-11-13 修回日期:2026-01-13 出版日期:2026-02-01
  • 通信作者: 李晋辉

Research progress on pathogenesis and treatment of white matter injury in premature infants

Wenjia Du1, Jinhui Li1,2,()   

  1. 1Department of Pediatrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
    2Department of Pediatrics, West China Second University Hospital (Tianfu), Sichuan University/Sichuan Provincial Children′s Hospital (Sichuan Provincial Children′s Medical Center), Meishan 620010, Sichuan Province, China
  • Received:2025-11-13 Revised:2026-01-13 Published:2026-02-01
  • Corresponding author: Jinhui Li
  • Supported by:
    National Key Research and Development Program of China(2023YFC2706402)
引用本文:

杜文佳, 李晋辉. 早产儿脑白质损伤的发病机制及治疗研究进展[J/OL]. 中华妇幼临床医学杂志(电子版), 2026, 22(01): 83-88.

Wenjia Du, Jinhui Li. Research progress on pathogenesis and treatment of white matter injury in premature infants[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2026, 22(01): 83-88.

脑白质损伤(WMI)是早产儿,特别是超早产儿出现严重神经系统并发症的主要病因。随着对早产儿更加精细化护理,相较于以往的脑室周围局灶性坏死性病变,早产儿WMI目前更普遍的表现为弥漫性白质损伤。WMI早产儿的核心病理学特征是晚期少突胶质前体细胞(preOL)的显著易损性、髓鞘形成障碍、轴突损伤和神经网络连接异常,进而影响早产儿神经系统发育及其功能。笔者拟概述早产儿WMI定义、高危人群、临床影像学表现及核心病理学特征,并且深入分析早产儿WMI发病机制与治疗策略的最新研究进展,旨在为临床进一步认识其病理生理过程及探索有效干预策略提供参考。

White matter injury (WMI) is a major cause of severe neurological complications in preterm infants, especially extremely preterm infants. With advances in neonatal care, the predominant pathological pattern of preterm WMI has shifted from focal necrotic lesions to diffuse injury. The core pathological features of preterm WMI include the significant vulnerability of late oligodendrocyte progenitor (preOL), dysmyelination, axonal injury, and abnormal neural network connectivity, which in turn affect nervous system development and function. This review summarizes the definition, high-risk population, clinical imaging manifestations, and pathological features of preterm WMI, and further discusses recent progress in its pathogenesis and therapeutic strategies, with the aim of providing a reference for understanding its pathophysiological mechanisms and exploring effective interventions.

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