中国神经再生研究(英文版) ›› 2024, Vol. 19 ›› Issue (4): 737-746.doi: 10.4103/1673-5374.382221

• 综述:脑损伤修复保护与再生 • 上一篇    下一篇

缺血性脑卒中后肌肉病理生理学变化:脑卒中损伤的次要后果

  

  • 出版日期:2024-04-15 发布日期:2023-09-15
  • 基金资助:
    国家自然科学基金青年科学基金项目(82104732),成都中医药大学杏林学者项目(BSH2020022),成都中医药大学西南地区特色中药资源系统研究重点实验室开放研究基金项目(2020XSGG002)

Pathophysiological changes of muscle after ischemic stroke: a secondary consequence of stroke injury

Hu Qi1, 2, #, Dan Tian3, #, Fei Luan1, 2, Ruocong Yang1, 2, *, Nan Zeng1, 2, *   

  1. 1State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China; 2School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China; 3Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
  • Online:2024-04-15 Published:2023-09-15
  • Contact: Nan Zeng, MD, 19932015@cdutcm.edu.cn; Ruocong Yang, MD, yangruocong@163.com.
  • Supported by:
    This work was supported by the National Natural Science Foundation of China for Young Scientists, No. 82104732 (to RY), Xinglin Scholar Project of Chengdu University of Traditional Chinese Medicine, No. BSH2020022 (to RY), and the Open Research Fund of Chengdu University of Traditional Chinese Medicine Key Laboratory of Systematic Research of Distinctive Chinese Medicine Resources in Southwest China, No. 2020XSGG002 (to NZ).

摘要:

充分的临床证据表明,缺血性脑卒中对机体的损害不仅发生在急性期,也发生在恢复期,且后者对患者的长期预后影响更为显著。然而,目前对于脑卒中的研究往往只关注中枢神经系统的病变,忽视了这种疾病引起的继发性损害。这种现象源于中枢神经系统领域的病理生理学研究进展缓慢,而现有的溶栓治疗时间窗和患者获益仍存在争议,需探索更为实用的干预策略。针对肢体症状的治疗措施可极大地改善患者的生活质量,这已经成为一种重要的干预策略。作为肢体最重要的组成部分,骨骼肌已经成为一个潜在的热点。尽管如此,仍然缺乏对脑卒中后骨骼肌的病理生理变化和潜在治疗方法的全面综述。此次综述填补了对脑卒中幸存者肌肉萎缩、炎症、神经再生、线粒体变化和营养失调的病理过程和机制的理解的空白。此外还讨论了脑卒中患者肌肉功能的个性化的康复方案现存的挑战和解决方案。

https://orcid.org/0000-0003-2090-4288 (Nan Zeng); https://orcid.org/0000-0002-7423-4737 (Ruocong Yang)

关键词: 缺血性脑卒中, 肌肉萎缩, 泛素, 康复, 肌肉纤维, 生活质量, 肌肉营养, 炎症, 线粒体, 废用

Abstract: Sufficient clinical evidence suggests that the damage caused by ischemic stroke to the body occurs not only in the acute phase but also during the recovery period, and that the latter has a greater impact on the long-term prognosis of the patient. However, current stroke studies have typically focused only on lesions in the central nervous system, ignoring secondary damage caused by this disease. Such a phenomenon arises from the slow progress of pathophysiological studies examining the central nervous system. Further, the appropriate therapeutic time window and benefits of thrombolytic therapy are still controversial, leading scholars to explore more pragmatic intervention strategies. As treatment measures targeting limb symptoms can greatly improve a patient’s quality of life, they have become a critical intervention strategy. As the most vital component of the limbs, skeletal muscles have become potential points of concern. Despite this, to the best of our knowledge, there are no comprehensive reviews of pathophysiological changes and potential treatments for post-stroke skeletal muscle. The current review seeks to fill a gap in the current understanding of the pathological processes and mechanisms of muscle wasting atrophy, inflammation, neuroregeneration, mitochondrial changes, and nutritional dysregulation in stroke survivors. In addition, the challenges, as well as the optional solutions for individualized rehabilitation programs for stroke patients based on motor function are discussed.

Key words: inflammation, ischemic stroke, mitochondria, muscle atrophy, muscle fiber, muscle nutrition, quality of life, rehabilitation, ubiquitin