脑出血中神经元的损伤与修复  

Neuronal damage and repair of intracerebral hemorrhage

作　　者：曾学翰 李丹 ZENG Xuehan;LI Dan(Department of Acupuncture and Moxibustion,the Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing100029,China)

机构地区：[1]北京中医药大学第三附属医院针灸科,北京100029

出　　处：《中国医药导报》2024年第25期56-60,共5页China Medical Herald

基　　金：国家自然科学基金面上资助项目(82174514)。

摘　　要：脑出血是第二常见的脑卒中亚型,主要由高血压引起,其死亡率和发病率高于缺血性脑卒中。脑出血导致的原发性和继发性脑损伤显著损害神经元的结构与功能,影响患者神经功能及生活质量。神经元损伤机制包括免疫炎症反应、氧化应激及铁毒性等。神经元保护与修复机制方面,主要分析免疫细胞(如小胶质细胞)在神经炎症中的双重角色。小胶质细胞既可清除损伤细胞,又可导致神经元损伤;星形胶质细胞则通过转移线粒体和吸收谷氨酸等方式为神经元提供保护。本文总结干细胞治疗的潜力,尤其是神经干细胞和间充质干细胞在促进神经元再生及组织修复中的应用,并探讨脑源性神经营养因子在神经保护和恢复中的重要性。铁死亡和氧化应激是导致脑出血后神经元损伤的关键因素,调控这些机制对提升神经元存活率至关重要。尽管近年来脑出血的临床前和临床研究不断增多,但有效治疗方法依然不足,因此,深入研究相关分子机制和治疗策略成为未来的重要任务,特别是在炎症调节、氧化应激缓解及神经元保护与再生方面。本文旨在明确研究方向,为提高脑出血患者康复率和生活质量提供理论基础。Intracerebral hemorrhage is the second common subtype of stroke,which is mainly caused by hypertension.Its mortality and incidence rate are higher than those of ischemic stroke.Primary and secondary brain damage caused by intracerebral hemorrhage significantly damages structure and function of neurons,affects patients’neurological function and quality of life.The mechanisms of neuronal damage include immune inflammatory response,oxidative stress,and iron toxicity.In terms of neuronal protection and repair mechanisms,the dual role of immune cells(such as microglia)in neuroinflammation is mainly analyzed.Microglia can both clear damaged cells and cause neuronal damage;astrocytes provide protection for neurons by transferring mitochondria and absorbing glutamate.This article summarizes the potential of stem cell therapy,especially the application of neural stem cells and mesenchymal stem cells in promoting neuronal regeneration and tissue repair,and explores the importance of brain-derived neurotrophic factor in neuroprotection and recovery.Ferroptosis and oxidative stress are key factors leading to neuronal damage after intracerebral hemorrhage,and regulating these mechanisms is crucial for improving neuronal survival rates.Despite the increasing number of preclinical and clinical studies on intracerebral hemorrhage in recent years,effective treatment methods are still insufficient.Therefore,in-depth research on relevant molecular mechanisms and treatment strategies has become an important task in the future,especially in inflammation regulation,oxidative stress relief,and neuronal protection and regeneration.This article aims to clarify the research direction and provide a theoretical basis for improving the rehabilitation rate and quality of life of patients with intracerebral hemorrhage.

关 键 词：神经元 脑出血 神经元损伤 神经元修复 机制研究 

分 类 号：R743.34[医药卫生—神经病学与精神病学]