中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2013, Vol. 8 ›› Issue (28): 2677-2686.doi: 10.3969/j.issn.1673-5374.2013.28.010

• 综述:神经损伤修复保护与再生 • 上一篇    

亚低温治疗中枢神经损伤：双刃剑谁更锋利？

  

  • 收稿日期:2013-03-05 修回日期:2013-07-17 出版日期:2013-10-05 发布日期:2013-10-05

Mild hypothermia as a treatment for central nervous system injuries Positive or negative effects?

Rami Darwazeh, Yi Yan   

  1. Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
  • Received:2013-03-05 Revised:2013-07-17 Online:2013-10-05 Published:2013-10-05
  • Contact: Yi Yan, Ph.D., Professor, Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China, yanyi2005@vip.sina.com, yanyi2005@gmail.com.
  • About author:Rami Darwazeh, Studying for master’s degree.

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摘要：

中枢神经系统损伤除引起局灶性神经损伤外，还能引起缺血、脑水肿、兴奋性中毒、氧化应激及钙稳态失调继发性损伤，研究发现亚低温治疗对多种急性中枢神经损伤有效。已证实亚低温治疗能有效治疗成人创伤性脑损伤伴颅内高压，也是增加缺血性损伤患者存活率、改善患者生活质量的一种较好的方法。低温通过减轻炎症、兴奋性毒性、自由基和降低颅内压，改善脑外伤和脑缺血后脑代谢，产生治疗中枢神经损伤的良好作用。但治疗性亚低温也会对中枢神经损伤患者带来一系列的生理和病理性变化，并可能发生不良反应，因而在临床应用亚低温治疗中枢神经损伤时还需进一步的炎症和摸索。

关键词: 神经再生, 综述, 脑损伤, 脊髓损伤, 中枢神经损伤, 亚低温, 治疗性亚低温, 创伤性脑损伤

Abstract:

Besides local neuronal damage caused by the primary insult, central nervous system injuries may secondarily cause a progressive cascade of related events including brain edema, ischemia, oxida-tive stress, excitotoxicity, and dysregulation of calcium homeostasis. Hypothermia is a beneficial strategy in a variety of acute central nervous system injuries. Mild hypothermia can treat high intra-cranial pressure following traumatic brain injuries in adults. It is a new treatment that increases sur-vival and quality of life for patients suffering from ischemic insults such as cardiac arrest, stroke, and neurogenic fever following brain trauma. Therapeutic hypothermia decreases free radical produc-tion, inflammation, excitotoxicity and intracranial pressure, and improves cerebral metabolism after traumatic brain injury and cerebral ischemia, thus protecting against central nervous system dam-age. Although a series of pathological and physiological changes as well as potential side effects are observed during hypothermia treatment, it remains a potential therapeutic strategy for central nervous system injuries and deserves further study.

Key words: neural regeneration, reviews, brain injury, spinal cord injury, central nervous system injury, mild hypothermia, therapeutic hypothermia, traumatic brain injury, neuroregeneration