天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (8): 957-960.doi: 10.11958/j.issn.0253-9896.2015.08.035

• 综述 • 上一篇    

蛛网膜下腔出血早期脑损伤的研究进展

王毅，张建宁   

  1. 天津医科大学总医院神经外科，天津市神经病学研究所
  • 收稿日期:2014-10-09 修回日期:2015-04-16 出版日期:2015-08-15 发布日期:2015-08-15
  • 通讯作者: 张建宁 E-mail:sinuosiwo@sina.com
  • 作者简介:王毅（1980），男，主治医师，硕士，主要从事脑血管病方面研究
  • 基金资助:
    国家自然科学基金青年项目（81200907）；天津市高校优秀青年教师资助计划（019-0020144）；天津市应用基础与前沿技术研究计划青年项目（12JCQNJC6800）

Current research on early brain injury in subarachnoid hemorrhage

WANG Yi, ZHANG Jianning   

  1. Department of Neurosurgery, Tianjin Medical University General Hospital; Tianjin Neurological Institute, Tianjin 300052, China
  • Received:2014-10-09 Revised:2015-04-16 Published:2015-08-15 Online:2015-08-15
  • Contact: ZHANG Jianning E-mail:sinuosiwo@sina.com

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摘要： 自发性蛛网膜下腔出血（SAH）后早期脑损伤（EBI）严重影响患者预后，已成为临床治疗和基础研究的关键时段。颅内动脉瘤（ICA）破裂后几分钟内即启动体内诸多病理生理反应，出现颅内压（ICP）增高导致颅内循环障碍，钙超载和钠、镁离子水平波动等脑细胞微环境中离子稳态失调，血脑屏障（BBB）破坏造成严重脑水肿，以及分子水平的改变都将加重SAH 患者的损伤。SAH 后EBI 是导致患者预后差的重要原因之一，随着其发病机制研究的深入，必将为SAH 的临床救治提供新的途径。

关键词: 蛛网膜下腔出血, 颅内动脉瘤, 脑损伤, 血管痉挛, 颅内, 综述

Abstract: Early brain injury (EBI) in spontaneous subarachnoid hemorrhage (SAH) plays an important role in prognosis and it become a key target period for clinical treatment and basic research. There were many pathophysiological change in the first few minutes after intracranial aneurysm ruptured. These include increased intracranial pressure (ICP) followed by in⁃ tracranial circulation disorders, calcium overload and sodium, magnesium level fluctuation, ion steady-state disorders in mi⁃ croenviroment of brain cells, serious brain edema due to blood brain barrier (BBB) damage, and changes in other molecules levels, all of which will aggravate SAH. EBI in SAH is one of the important factor that leads to poor prognosis. With the ad⁃ vancement of understanding its pathogenesis, new approach would be available to treat SAH in clinic.

Key words: subarachnoid hemorrhage, intracranial aneurysm, brain injuries, vasospasm, intracranial, review