动脉瘤性蛛网膜下腔出血后神经元损伤机制的研究进展

doi:10.16098/j.issn.0529-1356.2020.04.024

解剖学报 ›› 2020, Vol. 51 ›› Issue (4): 618-625.doi: 10.16098/j.issn.0529-1356.2020.04.024

动脉瘤性蛛网膜下腔出血后神经元损伤机制的研究进展

谢江淼杨晓梅*

北京大学医学部基础医学院人体解剖学与组织学胚胎学系，北京 100083

收稿日期:2019-05-08 修回日期:2019-07-26 出版日期:2020-08-06 发布日期:2020-08-06
通讯作者: 杨晓梅 E-mail:xiaomeiyang@bjmu.edu.cn
基金资助:
国家自然科学基金青年基金

Recent progress of the neural injury mechanism after aneurysmal subarachnoid hemorrhage

XIE Jiang-miao YANG Xiao-mei*

Department of Human Anatomy and Histoembryology， School of Basic Medical Sciences, Peking University Health Science Center，Beijing 100083,China

Received:2019-05-08 Revised:2019-07-26 Online:2020-08-06 Published:2020-08-06
Contact: YANG Xiao-mei E-mail:xiaomeiyang@bjmu.edu.cn

摘要/Abstract

摘要：

动脉瘤性蛛网膜下腔出血（aSAH）是脑卒中最严重的表现形式之一。颅内动脉瘤破裂后血液瘀滞在脑蛛网膜下腔，引起多种病理生理改变，包括脑积水、细胞凋亡、血脑屏障功能障碍、血管痉挛、微血栓形成和皮层扩散性抑制，这些机制相互作用并贯穿于整个脑损伤过程。近年来，临床试验逐渐关注aSAH发生后的两个阶段:早期脑损伤（EBI）和延迟性脑缺血(DCI)。这两个时期是导致神经元损伤的主要阶段，并与患者的预后密切相关。我们就近年来蛛网膜下腔出血后脑损伤的机制作一简要总结，主要讨论EBI和DCI在神经损伤中的作用。

关键词: 动脉瘤性蛛网膜下腔出血, 早期脑损伤, 延迟性脑缺血, 神经炎症, 脑血管痉挛

Abstract:

Aneurysmal subarachnoid hemorrhage (aSAH) is one of the most devastating form of stroke. Many physiopathology mechanisms ensue after cerebral aneurysm rupture with blood silting up in the subarachnoid space, including hydrocephalus, cell apoptosis, blood-brain barrier dysfunction, macrovascular vasospasm, microthrombosis and cortical spreading depolarization which interact with each other and work throughout the damage process. Recently, clinical trials gradually pay more attention to two phases of injury after aSAH: the early phase known as early brain injury (EBI) and the delayed phase, delayed cerebral ischemia (DCI). These two phases are main processes accounting for neural injury and are thought to be closely linked with the outcomes of the patients. This review makes a brief summary on the mechanism of cerebral injury after aSAH, mostly on EBI and DCI.

Key words: Aneurysmal subarachnoid hemorrhage, Early brain injury, Delayed cerebral ischemia, Neuroinflammation, Cerebral vasospasm

中图分类号:

R743.35

谢江淼杨晓梅 . 动脉瘤性蛛网膜下腔出血后神经元损伤机制的研究进展[J]. 解剖学报, 2020, 51(4): 618-625.

XIE Jiang-miao YANG Xiao-mei. Recent progress of the neural injury mechanism after aneurysmal subarachnoid hemorrhage[J]. Acta Anatomica Sinica, 2020, 51(4): 618-625.

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动脉瘤性蛛网膜下腔出血后神经元损伤机制的研究进展

Recent progress of the neural injury mechanism after aneurysmal subarachnoid hemorrhage

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