摘要
背景:血肿扩张是脑内出血(ICH)的有害事件,导致进行性神经系统恶化和不良结局。 目的:总结当前对血肿扩张机制的理解,并讨论治疗和预防的潜在方法。 结果:虽然血肿扩张的确切机制尚不清楚,但累积证据表明多种临床标志物如凝血/止血功能障碍,血压升高和BRAIN评分,血清葡萄糖和/或糖基化血红蛋白A1c,血清肌酐,因子XIII和国际 标准化比例(INR),降低血清胆固醇或低密度脂蛋白胆固醇和纤维蛋白原,可能与血肿扩张事件相关。 此外,几种分子途径的激活(即血浆激肽释放酶,血管性血友病因子,N-甲基-Daspartate及其受体,细胞因子/脂肪因子,细胞纤连蛋白和载脂蛋白Eε2等位基因)可导致血肿扩张。 结论:血肿扩张前瞻性研究如何预测患有血肿扩张风险最高的患者比限制急性ICH后血肿扩张本身更具挑战性。 寻求和检测可以适当干预的血浆中的风险标志物对于具有潜在血肿扩张的患者是有意义的,这可能有助于改善患有ICH的患者的临床结果。
关键词: 血肿扩张,预测因子,分子机制,药理治疗,分子干预,预防,脑内出血。
图形摘要
Current Drug Targets
Title:Hematoma Expansion: Clinical and Molecular Predictors and Corresponding Pharmacological Treatment
Volume: 18 Issue: 12
关键词: 血肿扩张,预测因子,分子机制,药理治疗,分子干预,预防,脑内出血。
摘要: Background: Hematoma expansion is a detrimental event of intracerebral hemorrhage (ICH) which results in progressive neurologic deteriorations and poor outcomes. Objective: To summariz the current understanding of the mechanisms underlying hematoma expansion and discuss the potential approaches of treatment and prevention.
Results: Although the exact mechanism of hematoma expansion is unclear, accumulating evidences suggest that multiple clinical markers such as coagulation/hemostasis dysfunction, higher blood pressure and BRAIN scores, higher serum glucose and/or glycosylated hemoglobin A1c, serum creatinine, Factor XIII and international normalized ratio (INR), lower serum cholesterol or LDL cholesterol, and fibrinogen, may be correlated with incidents of hematoma expansion. Furthermore, activation of several molecular pathways (i.e. plasma kallikrein, von Willebrand factor, N-methyl-Daspartate and its receptor, cytokines/ adipokines, cellular fibronectin and apolipoprotein Eε2 allele) may lead to hematoma expansion. Conclusion: Prospective study for hematoma expansion How to predict the patients Who are at highest risk of hematoma expansion is more challengeable than restricting hematoma expansion itself following acute ICH. Seeking and detecting risk markers in plasma that can be intervened appropriately is meaningful for patients with potential hematoma expansion, which may contribute to improve clinical outcomes in patients suffering from ICH.Export Options
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Cite this article as:
Hematoma Expansion: Clinical and Molecular Predictors and Corresponding Pharmacological Treatment, Current Drug Targets 2017; 18 (12) . https://dx.doi.org/10.2174/1389450117666160712092224
DOI https://dx.doi.org/10.2174/1389450117666160712092224 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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