西洛他唑治疗动脉瘤性蛛网膜下腔出血的作用机制和临床研究进展

Progress on mechanism and clinical research of cilostazol in treatment of aneurysmal subarachnoid hemorrhage

动脉瘤性蛛网膜下腔出血后的迟发性脑缺血是患者严重残疾甚至死亡的主要原因,迟发性脑缺血形成的主要危险因素是脑血管痉挛。西洛他唑是磷酸二酯酶Ⅲ的选择性抑制剂,可舒张血管、抗脂质过氧化、抗血管炎症因子、抑制基底动脉的表型转化和内皮损伤以及抑制腱糖蛋白-C。近年来一系列临床试验表明西洛他唑单用或者联合使用可有效治疗动脉瘤性蛛网膜下腔出血后的脑血管痉挛,进而改善迟发性脑缺血。回顾了西洛他唑在动脉瘤性蛛网膜下腔出血中的作用机制和临床研究,为进一步研究西洛他唑在动脉瘤性蛛网膜下腔出血中的应用提供参考。

Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage is the main cause of severe disability and even death in patients,and the main risk factor for the formation of delayed cerebral ischemia is cerebral vasospasm.Cilostazol is a selective inhibitor of phosphodiesterase III,which can dilate blood vessels,resist lipid peroxidation,inhibit vascular inflammatory factors,inhibit basal artery phenotype transformation and endothelial injury,and inhibit tenascin-C.In recent years,a series of clinical trials have shown that cilostazol alone or in combination can effectively treat cerebral vasospasm after aneurysmal subarachnoid hemorrhage,thereby improving delayed cerebral ischemia.This article reviews the mechanism of action and clinical research of cilostazol in treatment of aneurysmal subarachnoid hemorrhage,providing reference for further research on the application of cilostazol in treatment of aneurysmal subarachnoid hemorrhage.