天津医药 ›› 2017, Vol. 45 ›› Issue (8): 845-850.doi: 10.11958/20170661

• 专题 颅脑神经创伤 • 上一篇    下一篇

低温脑保护的分子学机制

王晶, 陈翀, 李晓红△   

  1. 王晶, 陈翀, 李晓红△
  • 收稿日期:2017-06-09 修回日期:2017-07-11 出版日期:2017-08-15 发布日期:2017-08-15
  • 通讯作者: △通讯作者 E-mail: lixiaohong12@hotmail.com E-mail:lixhchenc@163.com
  • 作者简介:王晶 (1991), 女, 研究生在读, 主要从事急重型颅脑创伤、 神经创伤、 亚低温治疗脑保护方面研究
  • 基金资助:
    国家自然科学基金资助项目(81471275, 81401067, 81541034); 天津市自然科学基金资助项目(15JCQNJC11100, 15JCYB? JC28100, 16JCYBJC27600)

The molecular mechanisms of hypothermia cerebral protection

WANG Jing, CHEN Chong, LI Xiao-hong△   

  1. WANG Jing, CHEN Chong, LI Xiao-hong△
  • Received:2017-06-09 Revised:2017-07-11 Published:2017-08-15 Online:2017-08-15
  • Contact: △Corresponding Author E-mail: lixiaohong12@hotmail.com E-mail:lixhchenc@163.com

摘要: 低温治疗也称目标温度管理 (TTM), 是指将身体核心体温降至 32~35 ℃。轻、 中度低温治疗可有效应用 于缺血性脑病、 颅脑创伤、 出血性卒中及其他形式的严重脑损伤等, 发挥神经保护作用。急性脑损伤、 脑缺血引发 的级联反应复杂多样, 目前的研究显示低温治疗发挥脑保护作用主要是从抑制代谢紊乱、 兴奋性毒性、 氧化应激反 应、 细胞凋亡、 炎症反应、 促进神经元再生以及维持血脑屏障完整性等方面来实现的。深入探讨低温治疗发挥神经 保护作用的分子机制有助于临床工作者更好地理解及完善低温治疗的适应证及禁忌证, 并为其他治疗方法与低温 疗法协同应用提供理论储备及临床实践可能。

关键词: 脑损伤, 低温治疗, 脑保护, 分子学机制

Abstract: Therapeutic hypothermia (TH), also known as targeted temperature management (TTM), is the intentional reduction of core body temperature to 32-35 ℃. Mild-to-moderate hypothermia and advanced cooling technology can be used as an effective component of multimodal therapy for ischemic encephalopathy, brain trauma, haemorrhagic stroke, or other forms of severe brain injury and acute neurological injuries to achieve neuroprotection. The events occured after an episode of acute neurological injuries and cerebral ischemia are multiple. And the possible explanation for the neuroprotective benefits of hypothermia therapy is inhibiting metabolic disruption, excitotoxicity, oxidative stress, cell apoptosis signals, inflammatory responses, and promoting neuronal integrity and blood-brain barrier integrity. To know the molecular mechanisms of action of TH, which exerts neuroprotective function, will provide clinicians a better understanding the indications and contraindications of this therapy, and provide a possible theoretical reserves and clinical practice for other therapies when used in conjunction with hypothermia.

Key words: brain injuries, therapeutic hypothermia, cerebral protection, molecular mechanisms