中国卒中杂志 ›› 2016, Vol. 11 ›› Issue (06): 494-500.

• 综述 • 上一篇    下一篇

蛛网膜下腔出血后迟发性脑血管痉挛的发病机制和治疗进展

王玉妹,唐思魏,石广志   

  1. 100050 北京首都医科大学附属北京天坛医院ICU
  • 收稿日期:2015-11-06 出版日期:2016-06-20 发布日期:2016-06-20
  • 通讯作者: 石广志shigzh@aliyun.com

Mechanism and Therapies of Delayed Cerebral Vasospasm after Subarachnoid Hemorrhage

  • Received:2015-11-06 Online:2016-06-20 Published:2016-06-20

摘要:

脑血管痉挛(cerebral vasospasm,CVS)是蛛网膜下腔出血(subarochnoid hemorrhage,SAH)最 严重的并发症,尤其是迟发性脑血管痉挛(delayed cerebral vasospasm,DCV),一旦发生可能会出现 脑缺血甚至死亡等严重并发症。目前其发病机制尚不明确,多种因素如红细胞分解产物、一氧化氮 (nitric oxide,NO)、内皮素、自由基和脂质过氧化物等均是导致DCV的重要因素,而对于治疗DCV的方 法也在持续探索中,SAH后DCV仍是目前面临的一大难题。本文主要对SAH后CVS的发病机制及治疗进 展进行综述。

文章导读: 迟发性脑血管痉挛是蛛网膜下腔出血最严重的并发症,本文主要对其发生机制及治疗进展进行综述。

关键词: 蛛网膜下腔出血; 迟发性脑血管痉挛; 发病机制; 治疗

Abstract:

Delayed cerebral vasospasm (DCV) after subarachnoid hemorrhage (SAH) is a serious medical complication, characterized by constriction of cerebral arteries leading to varying degrees of cerebral ischemia. Many pathological processes have been proposed to explain the pathogenesis of DCV after SAH, including oxy-hemoglobin, nitric oxide (NO), endothelin (ET), endothelial damage, smooth muscle contraction, changing in vascular responsiveness, and inflammatory and/or immunological response of the vascular wall. However the mechanism still remains unclear. And the therapies are still uncertain. This review addresses the mechanism and therapies of DCV after SAH.

Key words: Subarachnoid hemorrhage; Delayed cerebral vasospasm; Mechanism; Therapies