蛛网膜下腔出血早期脑损伤的研究进展

Current research on early brain injury in subarachnoid hemorrhage

自发性蛛网膜下腔出血(SAH)后早期脑损伤(EBI)严重影响患者预后,已成为临床治疗和基础研究的关键时段。颅内动脉瘤(ICA)破裂后几分钟内即启动体内诸多病理生理反应,出现颅内压(ICP)增高导致颅内循环障碍,钙超载和钠、镁离子水平波动等脑细胞微环境中离子稳态失调,血脑屏障(BBB)破坏造成严重脑水肿,以及分子水平的改变都将加重SAH患者的损伤。SAH后EBI是导致患者预后差的重要原因之一,随着其发病机制研究的深入,必将为SAH的临床救治提供新的途径。

Early brain injury （EBI） in spontaneous subarachnoid hemorrhage （SAH） plays an important role in prognosis and it become a key target period for clinical treatment and basic research. There were many pathophysiological change in the first few minutes after intracranial aneurysm ruptured. These include increased intracranial pressure （ICP） followed by intracranial circulation disorders, calcium overload and sodium, magnesium level fluctuation, ion steady-state disorders in microenviroment of brain cells, serious brain edema due to blood brain barrier （BBB） damage, and changes in other molecules levels, all of which will aggravate SAH. EBI in SAH is one of the important factor that leads to poor prognosis. With the advancement of understanding its pathogenesis, new approach would be available to treat SAH in clinic.