脑出血后血-脑屏障通透性增高机制与药物治疗的研究进展

Research progress on the mechanism and drug therapy of BBB permeability increase after intracerebral hemorrhage

自发性脑出血(ICH)是指原发性非外伤性脑实质内出血。尽管自发性ICH在脑卒中病例中所占比例不到20%,但仍是所有卒中类型中病死率最高的,同时具有高发病率、高致残率。血-脑屏障(BBB)能够限制分子运输,将中枢神经系统与血液循环分开,是一种物理和代谢屏障。在许多脑出血患者中,神经功能缺损的症状在早期逐渐恶化,BBB早期损害是导致神经损害的主要原因之一。研究表明,受损的BBB严重程度与脑出血后的不良预后密切相关,保护BBB的完整和维持其通透性是脑出血未来的主要治疗方法。因此,明确ICH后BBB通透性增高的相关机制,以期为寻找治疗靶点提供新的研究方向。

Intracerebral hemorrhage(ICH)is defined as primary non-traumatic intracranial parenchymal hemorrhage.Although spontaneous ICH accounts for less than 20%of stroke cases,it still has the highest mortali⁃ty rate with high morbidity and disability rate among all stroke types.The Blood brain barrier(BBB)is a physical and metabolic barrier that restricts molecular transport and separates the central nervous system from blood circu⁃lation.In many patients with intracerebral hemorrhage,the symptoms of neurological impairment gradually worsen in the early stage,and the early damage of BBB is one of the main causes of neurological damage.Studies have shown that the severity of damaged BBB is closely related to the poor prognosis after intracerebral hemorrhage,and protecting the integrity of BBB and maintaining its permeability are the main treatment methods for intracere⁃bral hemorrhage in the future.Therefore,clarifying the related mechanisms of increased BBB permeability after ICH is meant to provide new research directions for finding therapeutic targets.