摘要
大脑中动脉(MCA)是颅内动脉粥样硬化性狭窄的常见部位,血管内治疗是MCA狭窄患者的治疗方式之一,但术后高灌注综合征(HPS)及高灌注脑出血(HICH)是严重的并发症,且与不良预后相关。HICH的发生离不开HPS的病理生理学基础,脑血管自身调节机制受损、血-脑屏障结构受损以及一氧化氮和氧自由基的作用均可能参与了HICH的发生、发展。结合HPS影像学征象有助于HICH的诊断。虽然采用预测HPS的方法评估HICH的发生风险有局限性,但通过预测并防治HPS,有助于避免其进展为HICH。未来尚需更多的研究以获得循证医学证据。
Intracranial atherosclerotic stenosis is commonly seen in middle cerebral artery(MCA).Endovascular treatment is one of the therapeutic strategies for MCA stenosis,with postoperative hyperperfusion syndrome(HPS)and hyperperfusion-associated intracranial hemorrhage(HICH)as its serious complications which are associated with poor prognosis.The occurrence of HICH can be understood from the pathophysiology of HPS.Impaired cerebral vascular autoregulation,damaged blood-brain barrier and the effects of nitric oxide and oxygen free radicals may be involved in the occurrence and development of HICH.Combining HPS imaging features is helpful for the diagnosis of HICH.Despite using predictors of HPS to evaluate the risk of HICH has some limitations,it still can help to prevent HICH.In the future,further research is needed to obtain sufficient evidence.
作者
袁斌
张鑫
吴琪
文立利
尤宗琦
徐伟东
陈姝娟
邓金龙
Yuan Bin;Zhang Xin;Wu Qi;Wen Lili;You Zongqi;Xu Weidong;Chen Shujuan;Deng Jinlong(Department of Neurosurgery,Jinling Hospital,Jinling School of Clinical Medicine,Nanjing Medical University,Nanjing 211166,China)
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2019年第3期158-163,共6页
Chinese Journal of Cerebrovascular Diseases
基金
江苏省自然科学基金资助项目(BK20181240)
江苏省医学重点人才培养(ZDRCA2016094)
关键词
大脑中动脉
狭窄
血液灌注
颅内出血
综述
Middle cerebral artery
Stenosis
Hemoperfusion
Intracranial hemorrhages
Review
