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引用次数: 0
摘要
综述的目的:脑出血(ICH)是一种破坏性脑卒中,医学治疗手段有限;因此,及时探索新的治疗靶点至关重要。本综述重点探讨了除手术或止血外,减轻 ICH 后继发性脑损伤的最新策略,解决了临床实践中的一大空白,并强调了改善患者预后的潜力:最近发现:减少 ICH 后继发性脑损伤的治疗靶点前景广阔,包括减轻铁毒性和抑制铁变态反应、增强血肿的内源性吸收以及调节血肿周围的炎症反应和水肿。此外,新的研究表明,脑部淋巴系统可能在血肿清除和水肿控制方面发挥潜在作用。各种实验和早期临床试验表明,这些方法可能会带来潜在的临床益处,尽管大多数研究仍处于初步阶段。这些新兴靶点的临床转化可显著提高治疗干预的疗效,并有可能减少继发性脑损伤,改善神经功能的恢复。未来的工作重点应放在大规模临床试验上,以验证这些方法,为自发性 ICH 更有效的治疗方案铺平道路。
New targets in spontaneous intracerebral hemorrhage.
Purpose of review: Intracerebral hemorrhage (ICH) is a devastating stroke with limited medical treatments; thus, timely exploration of emerging therapeutic targets is essential. This review focuses on the latest strategies to mitigate secondary brain injury post-ICH other than targeting surgery or hemostasis, addressing a significant gap in clinical practice and highlighting potential improvements in patient outcomes.
Recent findings: Promising therapeutic targets to reduce secondary brain injury following ICH have recently been identified, including attenuation of iron toxicity and inhibition of ferroptosis, enhancement of endogenous resorption of hematoma, and modulation of perihematomal inflammatory responses and edema. Additionally, novel insights suggest the lymphatic system of the brain may potentially play a role in hematoma clearance and edema management. Various experimental and early-phase clinical trials have demonstrated these approaches may potentially offer clinical benefits, though most research remains in the preliminary stages.
Summary: Continued research is essential to identify multifaceted treatment strategies for ICH. Clinical translation of these emerging targets could significantly enhance the efficacy of therapeutic interventions and potentially reduce secondary brain damage and improve neurological recovery. Future efforts should focus on large-scale clinical trials to validate these approaches, to pave the way for more effective treatment protocols for spontaneous ICH.
期刊介绍:
Current Opinion in Neurology is a highly regarded journal offering insightful editorials and on-the-mark invited reviews; covering key subjects such as cerebrovascular disease, developmental disorders, neuroimaging and demyelinating diseases. Published bimonthly, each issue of Current Opinion in Neurology introduces world renowned guest editors and internationally recognized academics within the neurology field, delivering a widespread selection of expert assessments on the latest developments from the most recent literature.