心搏骤停复苏后脑神经元死亡机制研究进展  

Research progress on the mechanism of brain neuron death after cardiac arrest resuscitation

作　　者：徐若彤 高昌俊 Xu Ruotong;Gao Changjun(Department of the Third Student Battalion,School of Basic Medical Sciences of Air Force Medical University,Xi'an 710038,China;Department of Anesthesiology,Tangdu Hospital of Air Force Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学基础医学院三大队,西安710038 [2]空军军医大学唐都医院麻醉科,西安710038

出　　处：《国际麻醉学与复苏杂志》2024年第11期1205-1210,共6页International Journal of Anesthesiology and Resuscitation

基　　金：国家自然科学基金(81971225);陕西省自然科学基础研究计划重点项目(2023-JC-ZD-52)。

摘　　要：心搏骤停患者复苏后常遗留不同程度的神经系统功能障碍, 脑神经元的大量死亡是造成复苏后脑损伤的重要原因, 传统研究表明, 坏死和凋亡是复苏后脑神经元死亡的主要方式, 但随着细胞死亡机制研究的推进, 人们发现复苏后的神经元还可能通过铁死亡、焦亡、坏死性凋亡、泛凋亡及自噬等形式死亡。文章综述了心搏骤停及复苏后可能存在的神经元死亡途径, 对神经元死亡途径的充分理解将有助于在一定的级联反应中针对不同的步骤加以干预, 从而延缓细胞死亡或挽救功能失调的神经元, 对于减少神经系统后遗症发生率具有重要意义。此外, 文章还讨论了各种神经元死亡方式相关抑制药物的应用前景, 以期为复苏后脑保护提供更多理论参考。Post-cardiac arrest patients often experience various degrees of neurological dysfunction,with widespread death of brain neurons being a major cause of post-resuscitation brain injury.Traditional studies suggest that necrosis and apoptosis are the primary forms of neuronal death after resuscitation.However,with advances in research on cell death mechanisms,it has been discovered that neurons may also undergo ferroptosis,pyroptosis,necroptosis,PANoptosis,and autophagy following resuscitation.This article reviews the possible neuronal death pathways after cardiac arrest and resuscitation,emphasizing that a comprehensive understanding of these pathways can facilitate interventions targeting different steps of the cascade reaction,thereby delaying neuronal death or rescuing dysfunctional neurons.This is of great significance for reducing the incidence of neurological sequelae.Furthermore,the article discusses the potential application of various inhibitors targeting neuronal death mechanisms,in order to provide more theoretical reference for brain protection after resuscitation.

关 键 词：心搏骤停 心肺复苏 细胞铁死亡 细胞焦亡 细胞坏死性凋亡 自噬 

分 类 号：R541.78[医药卫生—心血管疾病]