蜂蜇并发脑梗死的临床诊治及发病机制研究进展

Advances in the pathogenesis and clinical diagnosis and treatment of cerebral infarction following bee/wasp sting

蜂蜇并发脑梗死临床罕见。其早期临床表现较一般脑梗死严重，尤其是意识水平，实验室检查多无特异性，颅脑CT／MRI检查多发现病灶累及2个或2个以上血管支配区域，部分闭塞血管可发生再通，激素和抗组胺治疗具有一定特异性，大部分患者预后较好。其病理生理机制复杂，目前认为可能与血管炎、血管痉挛、免疫功能亢进、脑组织低灌注及颈上交感神经节逆行性刺激等学说有关。

Bee/wasp sting associated ischemia stroke [s very rare. Its early clinical manifestation, especial level of consciousness, is serious than general cerebral infarction. There is no specificity with labo- ratory examination. Most of the infarction lesions involve two or two more regions detection by brain comput- erized tomographic scanning/magnetic resonance imaging （CT/MRI）. Parts of the occlusion vessels could recanalization. Therapy with hormones and antihistamine has certain effect. Most of patients have approving prognosis. The pathological mechanism is mainly associated with doctrine such as vascular inflammation, vascular spasm, immune hyperfunction, brain tissue hypoperfusion and retrograde stimulation of the superior cervical ganglion.