| 引用本文: |
周鑫, 李兰, 付子煜, 欧阳林旗, 胡华, 陈镇, 邓桂明.脑缺血再灌注不同阶段的损伤机制及中药干预作用[J].湖南中医药大学学报,2025,45(6):1179-1186[点击复制] |
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| 脑缺血再灌注不同阶段的损伤机制及中药干预作用 |
| 周鑫,李兰,付子煜,欧阳林旗,胡华,陈镇,邓桂明 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007;湖南中医药大学第二附属医院, 湖南 长沙 410005) |
| 摘要: |
| 脑缺血再灌注损伤（CIRI）是脑卒中后常见并发症，其发病机制复杂，临床预后欠佳。CIRI可划分为急性缺血期、再灌注早期及再灌注后期，不同阶段损伤机制各具特征又相互影响，共同加速病程进展，最终导致不可逆脑损伤。急性缺血期以能量代谢障碍和钙离子超载为主；再灌注早期氧化应激与炎症反应剧烈；再灌注后期铁死亡和神经再生障碍导致脑组织不可逆损伤。中药治疗CIRI具有独特优势，可通过抗氧化应激、抑制炎症反应、保护线粒体功能、调节钙离子稳态等多途径、多靶点协同作用，综合改善CIRI病理进程。本文系统梳理CIRI阶段性损伤机制，总结中药干预CIRI的实验研究进展，以期为中药治疗CIRI的机制研究及临床转换提供新思路。 |
| 关键词: 脑缺血再灌注 中药 中药单体 中药复方 发病机制 作用机制 |
| DOI：10.3969/j.issn.1674-070X.2025.06.029 |
| 投稿时间：2025-03-25 |
| 基金项目:湖南省中医药科研计划重点课题（A2023015）；长沙市科技计划项目科技创新平台项目（kh2201060）。 |
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| Injury mechanisms at different stages of cerebral ischemia-reperfusion and the interventional effects of Chinese medicines |
| ZHOU Xin, LI Lan, FU Ziyu, OUYANG Linqi, HU Hua, CHEN Zhen, DENG Guiming |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China;The Second Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410005, China) |
| Abstract: |
| Cerebral ischemia-reperfusion injury (CIRI), a common complication following stroke, is characterized by complex pathogenesis and poor clinical prognosis. CIRI can be divided into three phases: acute ischemia, early reperfusion, and late reperfusion. Each phase exhibits distinct yet interconnected injury mechanisms that collectively accelerate disease progression, ultimately leading to irreversible brain damage. The acute ischemic phase is dominated by energy metabolism dysfunction and calcium overload; the early reperfusion phase is marked by severe oxidative stress and inflammatory responses; while the late reperfusion phase involves ferroptosis and impaired neurogenesis, contributing to irreversible brain tissue damage. Chinese medicines demonstrates unique advantages in treating CIRI by exerting synergistic effects through multiple pathways and targets, such as antioxidant stress, inhibiting inflammatory responses, protecting mitochondrial function, and regulating calcium ion homeostasis, thereby comprehensively ameliorating the pathological process of CIRI. This paper systematically reviews the phased injury mechanisms of CIRI and summarizes the experimental research progress of Chinese medicines interventions in CIRI, aiming to provide new insights for the mechanistic study and clinical translation of Chinese medicines in treating CIRI. |
| Key words: cerebral ischemia-reperfusion Chinese medicines Chinese medicine monomer Chinese medicine compound pathogenesis mechanism of action |
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