脑梗死与脑出血急性期肠道屏障破坏的发病机制及其相关指标的研究进展

Research Progress in Pathogenesis and Related Indicators of Intestinal Barrier Damage of Cerebral Infarction and Intracerebral Hemorrhage at Acute Stage

脑梗死是一种急性脑功能缺损疾病,诱发脑梗死的原因是脑部血管突然破裂或阻塞引起的脑局部血液循环障碍,脑梗死症状会持续超过24h,故也称之为出血性或缺血性脑梗死。其高发病率、高病死率、高致残率的特点给社会和家庭带来沉重的负担。目前缺血性脑梗死的治疗对于时间窗内患者可以采取静脉溶栓和动脉取栓的方式治疗,对于时间窗外的重症脑梗死患者目前尚无有效治疗手段。出血性脑梗死根据出血部位、出血量不同由手术血肿清除或保守治疗。探究卒中病理生理机制的相关影响因素,并进行有效干预,可能有助于提高脑梗死患者神经功能恢复及远期生活质量。免疫炎症、氧化应激、神经炎症、神经细胞死亡等被认为是参与脑梗死的重要机制。而肠道黏膜屏障作为维持肠道稳态的重要部分,当神经系统受到应激状态的干扰时,可通过肠-脑轴参与脑梗死后的免疫炎症反应而引起免疫紊乱。

Cerebral apoplexy is an acute cerebral functional defect disease,which is caused by sudden rupture or blockage of cerebral blood vessels,causing local blood circulation disorders of brain.Stroke symptoms may persist for more than 24 hours,which is known as hemorrhagic or ischemic stroke.Its high incidence rate,high mortality and high disability rate have brought heavy burden to society and families.Currently,its treatment includes intravenous thrombolysis and arterial embolectomy within the time window,there is no effective treatment for patients with severe cerebral infarction outside the time window.Hemorrhagic stroke can be treated surgically or conservatively depending on location and bleeding amount.Exploring relevant influencing factors of pathophysiological mechanism of stroke and conducting effective interventions may contribute to neurological recovery and long-term life quality of stroke patients.Immune inflammation,oxidative stress,neuroinflammation,and neuronal cell death is considered important mechanism involved in stroke.As an important part of maintaining intestinal homeostasis,intestinal mucosal barrier can participate in the immune inflammatory response after stroke through gut brain axis and cause immune disorders when the nervous system is disturbed by stress.