神经炎症在动脉瘤性蛛网膜下腔出血后早期脑损伤中的作用

早期脑损伤（early brain injury，EBI）是影响动脉瘤性蛛网膜下腔出血（aneurysmal subarachnoid hemorrhage，aSAH）患者预后的重要因素之一。目前aSAH后EBI产生机制尚不明确，神经炎 症可能为其主要驱动因素，其作用机制包括：红细胞降解产物和激活的小胶质细胞诱导神经炎症促 进神经元凋亡；神经炎症通过激活星形胶质细胞破坏血脑屏障导致脑水肿，并募集外周中性粒细胞 黏附于颅内微脉管系统引起微血管功能障碍导致脑皮质灌注不足。应用针对神经炎症不同靶点的 药物预防EBI可能是当前治疗aSAH的新方向。

The Role of Neuroinflammation in Early Brain Injury after Aneurysmal Subarachnoid Hemorrhage

Early brain injury (EBI) is one of the important factors affecting the prognosis of
patients with aneurysmal subarachnoid hemorrhage (aSAH). At present, the mechanism of EBI
after aSAH is not clear, and neuroinflammation may be the main driving factor. Its mechanism
includes that red blood cell degradation products and activated microglia induce neuroinflammation
and promote neuronal apoptosis; neuroinflammation activates astrocytes to destroy the blood-brain
barrier, leading to brain edema, and recruits peripheral neutrophils to adhere to the intracranial
microvasculature, causing microvascular dysfunction, and leading to insufficient cerebral cortex
perfusion. The novel drugs targeted at neuroinflammation to prevent EBI may be a new direction
for the current treatment of aSAH.