摘要
卒中后吞咽障碍是卒中后常见并发症,指患者由于卒中导致吞咽过程中的困难表现,其发生、发展的分子机制尚未阐明。调控吞咽功能的两个关键区域孤束核和疑核,其分泌的多种神经递质与吞咽功能密切相关。与孤束核密切相关的5-羟色胺(5-hydroxytryptamine,5-HT)及其受体5-HT1A、谷氨酸及N-甲基-D-天冬氨酸受体(N-methyl-D-aspartate receptor,NMDAR)等递质,以及与疑核密切相关的生长激素抑制素、一氧化氮合酶能神经元、谷氨酸、γ-氨基丁酸等递质,在吞咽的启动、控制及相关活动中发挥了重要作用。本文结合当前分子生物学领域最新成果发现,卒中后吞咽障碍可能的发病机制与背侧区的孤束核及周围的网状结构组成的脑干吞咽中枢,以及位于腹侧区的疑核及周围的网状结构密切相关。
Post-stroke dysphagia is a common complication after stroke,which refers to the difficulty in swallowing due to stroke.The molecular mechanism of post-stroke dysphagia occurrence and development has not been clarified.The nucleus tractus solitarius and nucleus ambiguus,the two key regions of regulating swallowing function,can secrete a variety of neurotransmitters which are closely related to swallowing function.The neurotransmitters such as 5-HT and 5-HT1A receptors,glutamate(Glu) and NDMA receptors in nucleus tractus solitarius,and calcitonin gene-related peptide(CGRP) and SOM,NOS neurons,glutamate,GABA in the nucleus ambiguous,all play an important role in the initiation,control and related activities of swallowing.Combined with the latest achievements in the field of molecular biology,the possible pathogenesis of post-stroke dysphagia were elaborated in this article.
作者
华晓琼
李彦杰
金小琴
刘昊源
张淑芹
牛丽
HUA Xiaoqiong;LI Yanjie;JIN Xiaoqin;LIU Haoyuan;ZHANG Shuqin;NIU Li(School of Rehabilitation Medicine,Henan University of Chinese Medicine,Zhengzhou 450046,China;Department of Rehabilitation,Henan Province Hospital of Traditional Chinese Medicine,Zhengzhou 450002,China)
出处
《中国卒中杂志》
2022年第3期318-323,共6页
Chinese Journal of Stroke
基金
河南省中医药科学研究专项课题(2019ZYBJ14)
河南省中医药拔尖人才培养项目(豫中医科教[2018]35号)。
