Zhang John H, Lo Takkin, Mychaskiw George, Colohan Austin
Department of Neurosurgery, Loma Linda University, Loma Linda, CA, USA; Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, CA, USA.
Pathophysiology. 2005 Jul;12(1):63-77. doi: 10.1016/j.pathophys.2005.01.003.
Cerebral vascular diseases, such as neonatal encephalopathy and focal or global cerebral ischemia, all result in reduction of blood flow to the affected regions, and cause hypoxia-ischemia, disorder of energy metabolism, activation of pathogenic cascades, and eventual cell death. Due to a narrow therapeutic window for neuroprotection, few effective therapies are available, and prognosis for patients with these neurological injuries remains poor. Hyperbaric oxygen (HBO) has been used as a primary or adjunctive therapy over the last 50 years with controversial results, both in experimental and clinical studies. In addition, the mechanisms of HBO on neuroprotection remain elusive. Early applications of HBO within a therapeutic window of 3-6h or delayed but repeated administration of HBO can either salvage injured neuronal tissues or promote neurobehavioral functional recovery. This review explores the discrepancies between experimental and clinical observations of HBO, focusing on its therapeutic window in brain injuries, and discusses the potential mechanisms of HBO neuroprotection.
脑血管疾病，如新生儿脑病和局灶性或全脑缺血，均会导致受影响区域的血流减少，并引起缺氧缺血、能量代谢紊乱、致病级联反应激活，最终导致细胞死亡。由于神经保护的治疗窗口期狭窄，几乎没有有效的治疗方法，这些神经损伤患者的预后仍然很差。在过去50年中，高压氧（HBO）一直被用作主要或辅助治疗方法，但在实验和临床研究中结果存在争议。此外，HBO的神经保护机制仍不明确。在3-6小时的治疗窗口期内早期应用HBO或延迟但重复给予HBO，既可以挽救受损的神经元组织，也可以促进神经行为功能恢复。本综述探讨了HBO实验和临床观察结果之间的差异，重点关注其在脑损伤中的治疗窗口期，并讨论了HBO神经保护的潜在机制。
