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缺血性脑卒中后脑水肿的发病机制及治疗进展
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Abstract:
缺血性脑卒中已成为全球死亡和残疾的主要原因。脑水肿是缺血性脑卒中的严重并发症，会引起颅内压升高，神经系统症状迅速恶化，形成脑疝，是脑卒中后不良结局的重要危险因素。迄今为止，脑卒中后脑水肿的详细机制尚不清楚。这限制了预防和治疗策略以及药物开发的进展。本文就脑水肿的分类、病理特点、缺血性脑卒中后脑水肿的发生机制与水通道蛋白4、SUR1-TRPM4通道、基质金属蛋白酶9、microRNA、脑静脉回流、炎症反应的关系进行综述。综述了脑卒中后脑水肿治疗新药的研究进展。因此，本文综述为进一步研究和临床治疗缺血性脑卒中后脑水肿提供参考。
Ischemic stroke is associated with increasing morbidity and has become the main cause of death and disability worldwide. Cerebral edema is a serious complication arising from ischemic stroke. It causes an increase in intracranial pressure, rapid deterioration of neurological symptoms, and formation of cerebral hernia, and is an important risk factor for adverse outcomes after stroke. To date, the detailed mechanism of cerebral edema after stroke remains unclear. This limits advances in prevention and treatment strategies as well as drug development. This review discusses the classification and pathological characteristics of cerebral edema, the possible relationship of the development of cerebral edema after ischemic stroke with aquaporin 4, the SUR1-TRPM4 channel, matrix metalloproteinase 9, microRNA, cerebral venous reflux, inflammatory reactions. It also summarizes research on new therapeutic drugs for post-stroke cerebral edema. Thus, this review provides a reference for further studies and for clinical treatment of cerebral edema after ischemic stroke.
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