蛛网膜下腔出血后迟发性脑缺血机制和治疗

The Pathogenesis and Treatment of Delayed Cerebral Ischemia after Subarachnoid Hemorrhage

动脉瘤性蛛网膜下腔出血是一种发病率和病死率都较高的疾病。迟发性脑缺血(DCI)是导致患者高病死率的主要原因。DCI的发病机制涉及脑血管痉挛、皮层扩散抑制、微血栓形成、微循环功能障碍等。治疗方法包括循环动力治疗、血管内治疗、尼莫地平、他汀类药物、硫酸镁及其他药物治疗。现主要从发病机制及治疗方法等方面对DCI予以综述。

Aneurysmal subarachnoid hemorrhage is a disease with high mortality and morbidity.Delayed cerebral ischemia（DCI）is the major reason that leads to high mortality.The pathogenesis of DCI includes cerebral vasospasm,cortical spreading depression,microthrombosis and microcirculatory dysfunction and so on.The treatment of DCI contains hemodynamic therapy,endovascular treatment,nimodipine,statins,magnesium sulfate and other drugs.Here is to review the pathogenesis and treatment of DCI.