大脑中动脉供血区梗死后远隔部位继发性损害的研究进展

临床和动物实验研究均已证明，脑梗死造成的神经功能缺损不仅与梗死灶局部损伤有关，而且也与远离梗死灶的相关部位的继发性损害有关。大鼠一侧大脑中动脉永久闭塞不仅造成同侧大脑皮质、尾壳核和豆状核梗死，而且引起远离梗死灶与大脑皮质有大量纤维联系的丘脑、黑质、海马、脑干和脊髓继发性退行性改变。脑梗死后远隔部位继发性损害的机制可能与轴突的退行性改变、神经营养障碍、存在神经生长抑制因子、局部脑血流减少、神经递质调节失衡和蛋白合成抑制等因素有关。这些研究有助于指导卒中后的康复治疗。

Advance in Research on Secondary Damage Remote from Mickae Cerebral Artery Infarction

Clinical and experimental researches have demonstrated that the neurological deficit caused by cerebral infarction is not only associated with the focal injury in local areas, but also associated with the secondary lesions remote from the infarct-related regions. The permanent unilateral middle cerebral artery occlusion in rats not only causes infarctions in ipsilateral cerebral cortex, caudate nucleus and lenticular nucleus, but also causes secondary retrograde degeneration in thalamus, substantia nigra, hippocampus, brain stem and spinal cord which have considerable fiber connections with the cerebral cortex. The mechanisms of the secondary damage remote from infarction may be associated with the factors of axonal retrograde degeneration, neurotrophic disturbance, existence of neural growth inhibitory factors, decrease of focal cerebral blood flow, disequilibrium of neurotransmitter adjustment, and inhibition of protein synthesis. These studies are helpful to guide the rehabilitation treatment after stroke.