特发性颅高压的研究现状及进展

Current status and progress of idiopathic intracranial hypertension

特发性颅高压是一种临床表现为颅内压升高、头痛、视乳头水肿、视力丧失的疾病,主要见于育龄期肥胖女性,严重威胁患者视力及生活质量。然而,驱动颅内压升高的潜在病理生理机制尚不清楚。既往理论主要集中在脑脊液循环异常,但近年来逐步认识到胶质淋巴系统异常、肥胖相关的代谢功能紊乱和雄激素、糖皮质激素失调参与该疾病的发生;监测技术的OCT检查及遥测颅内压监测仪,能够实现对患者颅内压波动的监测,为预防和延缓特发性颅高压并发症提供了帮助;此外,新型靶向药物11β-HSD1抑制剂和胰高血糖素样肽1的受体激动剂为特发性颅高压的治疗提供了更多新的选择。

Idiopathic intracranial hypertension(IIH)is clinically characterized by elevated intracranial pressure,headaches,papilledema,and vision loss,predominantly affecting obese women of childbearing age.IIH poses a significant threat to patients'vision and quality of life.However,the underlying pathophysiological mechanisms driving the increase in intracranial pressure remain unclear.Previously,theories primarily focused on abnormalities in cerebrospinal fluid circulation,but in recent years,it has been gradually recognized that abnormal glymphatic system,obesity-related metabolic dysfunction,androgen and glucocorticoid disorders are involved in the occurrence of this disease.OCT examination and telemetry intracranial pressure monitor can monitor the fluctuation of intracranial pressure in patients,which provides help for the prevention and delay of complications of idiopathic intracranial hypertension.Furthermore,novel targeted drugs,such as 11β-HSD1 inhibitors and glucagon-like peptide-1 receptor agonists,offer new therapeutic options for managing IIH.