蛛网膜下腔出血后脑血管痉挛的原因及治疗新进展

New Development of the Causes and Therapy of Cerebral Vasospasm Following Subarachnoid Hemorrhage

脑血管痉挛是蛛网膜下腔出血后常见的并发症,其所致迟发性缺血性神经功能损害是患者致残和死亡的最主要原因。虽经多年研究,但其发病机制至今尚未完全阐明。一氧化氮、内皮素1、血红蛋白氧化产物及炎性反应均被认为参与致病过程。针对这些发病机制的治疗措施目前仍处于研究阶段,其在脑血管痉挛的防治中将发挥重要作用。

Cerebral vasospasm is a severe complication in patients with subarachnoid hemorrhage. The following delayed ischemic neurological deficits are the leading cause of death and disability. Despite the potentially devastating consequences of cerebral vasospasm, the mechanisms remain unclear. Nitric oxide, endothelin-1, bilirubin oxidation products and inflammation appear to figure prominently in its pathogenesis. Therapies directed to these mechanisms are currently under investigation and will be effective to solute this substantial problem.