蛛网膜下腔出血后继发性脑血管痉挛的研究进展

doi:10.16098/j.issn.0529-1356.2019.04.023

摘要/Abstract

摘要：

蛛网膜下腔出血（SAH）约占所有脑卒中患者的5%，具有极高的致残率和致死率。SAH后继发性脑血管痉挛（CVS）导致流向大脑重要部位的血液中断，进而引起脑缺血，是导致SAH后高致残率和死亡率的主要并发症之一，通常发生在SAH之后的3～12 d，平均持续两周。SAH后CVS的发生机制十分复杂，是多因素、多环节共同参与的过程，主要包括溶血产物产生，血管舒张收缩因子失衡，炎症、信号级联反应的激活及细胞凋亡及相关基因的表达。SAH后CVS的治疗分为介入治疗和药物治疗。有效地预测、预防和治疗CVS将显著提高SAH后患者的生存率及生活质量。我们就SAH后脑血管痉挛的发生机制及治疗措施的研究进展进行简要综述。

关键词: 蛛网膜下腔出血, 脑血管痉挛, 脑卒中, 脑损伤

Abstract:

Subarachnoid hemorrhage (SAH) accounts for about 5% of all stroke patients, with high disability and mortality. Secondary cerebral vasospasm (CVS) after SAH interrupts cerebral blood flow to important parts of the brain, and then causes cerebral ischemia, which is one of the major complications of the disability and mortality. CVS usually occurring 3 to 12 days after SAH and lasted for an average of two weeks. The mechanism of CVS after SAH is very complex, and it is a process involving multiple factors and links, including hemolysis products, imbalance of vasodilator and vasoconstrictors, inflammation, activation of signal cascade reaction, apoptosis and expression of related genes. The treatment of CVS after SAH is divided into interventional therapy and drug therapy. Effective prediction, prevention, and treatment of CVS will significantly improve survival and quality of life after SAH. This article briefly reviews progress of the research on the mechanism and treatment of cerebral vasospasm af er SAH.

Key words: Subarachnoid hemorrhage, Cerebral vasospasm, Stroke, Brain injury

刘思齐张艳孙娟陈春花 . 蛛网膜下腔出血后继发性脑血管痉挛的研究进展[J]. 解剖学报, 2019, 50(4): 537-542.

LIU Si-qi ZHANG Yan SUN Juan CHEN Chun-hua. Progress of mechanism and therapy on cerebral vasospasm after subarachnoid hemorrhage[J]. Acta Anatomica Sinica, 2019, 50(4): 537-542.

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