动脉瘤性蛛网膜下隙出血的炎症机制与治疗研究进展  

Research progress on inflammatory mechanism and treatment in aneurysmal subarachnoid hemorrhage

作　　者：张明 宋校伟 甘小葵 方一鸣 黄保胜 Zhang Ming;Song Xiao-Wei;Gan Xiao-Kui;Fang Yi-Ming;Huang Bao-Sheng(Department of Neurosurgery,Sir Run Hospital Affiliated to Nanjing Medical University,Nanjing,Jiangsu 210016,China)

机构地区：[1]南京医科大学附属逸夫医院神经外科,江苏南京210016

出　　处：《解放军医学杂志》2024年第11期1336-1342,共7页Medical Journal of Chinese People's Liberation Army

基　　金：南京市医学科技发展资金资助项目(YKK19167)。

摘　　要：动脉瘤性蛛网膜下隙出血(aSAH)主要由颅内动脉瘤破裂引起,出血发生在蛛网膜下隙,是一种致残率和病死率均较高的急性神经系统疾病。aSAH相关的脑损伤是多种损伤机制共同导致的,发病后72 h内发生的早期脑损伤(EBI)为随后脑内的病理生理变化和不良预后奠定了基础。其中,脑免疫炎症反应涉及多种免疫细胞和活性物质相互作用,在aSAH后EBI中起重要作用,也与延迟性脑损伤及远期预后有关。aSAH后的全身性炎症反应将影响患者的预后及转归。本文综述了局部和全身免疫炎症反应在aSAH发生和发展中的作用,以及相关的炎性生物标志物和治疗方法的研究进展,旨在为相关治疗方案的探索提供参考。Aneurysmal subarachnoid hemorrhage(aSAH),primarily caused by the rupture of intracranial aneurysms with bleeding into the subarachnoid space,is an acute neurological disease associated with high disability and mortality.Brain injury after aSAH results from a combination of injury mechanisms,with early brain injury(EBI)occurring within 72 hours post-onset,laying the foundation for subsequent pathophysiological changes in the brain and poor prognosis of patients.Among them,the brain immunoinflammatory response,involving the interaction of various immune cells and active substances,plays a significant role in postaSAH EBI,and is related to delayed brain injury and long-term prognosis.Systemic inflammatory response following aSAH can also affect the prognosis and outcome of patients.This review summarizes the role of local and systemic immune inflammatory responses in the occurrence and progression of aSAH,as well as the research progress on related inflammatory biomarkers and therapeutic prospects,aiming to provide a theoretical reference for new treatment for aSAH.

关 键 词：蛛网膜下隙出血 炎症机制 治疗 转归 

分 类 号：R743.3[医药卫生—神经病学与精神病学]