摘要
随着血管内治疗(endovascular therapy,EVT)技术的发展,缺血性脑卒中(ischemic stroke,IS)患者的再通率已超过80%。然而,其中50%以上的患者在血管再通后未能获得良好的神经功能预后,被称为“无效再通”(futile recanalization,FR)。神经炎症是IS病理进程中的关键环节,与FR的发生发展密切相关。本文系统综述了神经炎症在FR中的核心作用机制,包括无复流现象、脑缺血再灌注损伤和脑-肠轴;对多种炎症相关生物标志物的挖掘有望协助早期识别FR高风险患者;TLR4拮抗剂、神经保护剂及中医药复方制剂通过调控神经炎症展现出针对FR的治疗潜力,靶向神经炎症的干预手段有望成为改善IS患者预后的潜在策略。
With the advancement of endovascular therapy(EVT)techniques,the recanalization rate for patients with ischemic stroke(IS)has exceeded 80%.However,more than 50%of patients fail to achieve favorable neurological outcomes following recanalization,a phenomenon termed“futile recanalization”(FR).Neuroinflammation plays a pivotal role in the pathological progression of IS and is closely associated with the development of FR.This systematic review synthesizes the pivotal role of neuroinflammation in FR,encompassing three core pathological mechanisms:the no-reflow phenomenon,cerebral ischemia-reperfusion injury,and the gut-brain axis.The identification of various inflammation related biomarkers shows promise for early detection of high-risk FR patients.Therapeutic agents including TLR 4 antagonists(e.g.ApTOLL),neuroprotective compounds,and traditional Chinese medicine formulations demonstrate treatment potential through modulation of neuroinflammatory pathways.Targeted interventions against neuroinflammation may emerge as a strategic approach to improve clinical outcomes in IS patients.
作者
曾晓莹
高徐璇
尹恝
ZENG Xiaoying;GAO Xuxuan;YIN Jia(The Department of Neurology of Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)
出处
《中国神经精神疾病杂志》
北大核心
2025年第8期490-495,共6页
Chinese Journal of Nervous and Mental Diseases
基金
国家自然科学基金面上项目(编号:82171317)
国家自然科学基金面上项目(编号:81870936)
国家自然科学基金青年科学基金项目(编号:82301456)。
关键词
缺血性脑卒中
神经炎症
无效再通
血管内治疗
无复流现象
缺血再灌注损伤
脑-肠轴
Ischemic stroke
Neuroinflammation
Futile recanalization
Endovascular therapy
No-reflow phenomenon
Cerebral ischemia-reperfusion injury
Brain-gut axis
