引用本文:李雪峰,王建村(综述),胡观成(审校).动脉瘤性蛛网膜下腔出血后延迟性脑缺血的研究进展[J].中国临床新医学,2020,13(5):532-536.
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动脉瘤性蛛网膜下腔出血后延迟性脑缺血的研究进展
李雪峰,王建村(综述),胡观成(审校)
416000 湖南,吉首大学医学院(李雪峰,胡观成);427000 湖南,张家界市人民医院神经外科(李雪峰,王建村,胡观成)
摘要:
[摘要] 延迟性脑缺血(delayed cerebral ischemia,DCI)作为影响动脉瘤性蛛网膜下腔出血后神经功能损伤重要原因,曾一度被理解为是仅由脑血管痉挛导致的,有部分学者甚至将DCI直接定义为发生脑血管痉挛的不良预后。但目前研究表明,造成DCI的相关发病机制可能不止如此,目前获得较多认同的机制有:早期脑损伤、皮质弥散去极化、微血栓形成、微循环痉挛、脑血流自动调节障碍、氧化应激和活性氧自由基生成,其他机制如细胞死亡、炎症反应、血脑屏障破坏等。该文对动脉瘤性蛛网膜下腔出血后DCI的研究进展作一综述。
关键词:  动脉瘤性蛛网膜下腔出血  延迟性脑缺血  发病机制
DOI:10.3969/j.issn.1674-3806.2020.05.26
分类号:R 743.35
基金项目:
Research progress in delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage
LI Xue-feng, WANG Jian-cun, HU Guan-cheng
Jishou University School of Medicine, Hunan 416000, China
Abstract:
[Abstract] Delayed cerebral ischemia(DCI), as an important cause of neurological impairment after aneurysmal subarachnoid hemorrhage(aSAH), was once understood to be caused only by cerebral vasospasm and some scholars also directly defined DCI as the adverse prognosis of cerebral vasospasm. However, current researches show that the potential pathogenesis of DCI may be more than that. At present, there are more recognized mechanisms: early brain injury, cortical spreading depolarizations, microthrombosis, microvascular spasm, cerebral blood flow autoregulation disorders, oxidative stress and reactive oxygen species free radical production, and other mechanisms, such as cell death, inflammatory response, blood-brain barrier damage, etc. In this paper, we review the research progress in DCI after aSAH.
Key words:  Aneurysmal subarachnoid hemorrhage(aSAH)  Delayed cerebral ischemia(DCI)  Pathogenesis