Konstas Angelos-Aristeidis, Choi Jae H, Pile-Spellman John
Department of Radiology, Columbia University, New York, NY 10032, USA.
Neurocrit Care. 2006;4(2):168-78. doi: 10.1385/NCC:4:2:168.
The development of animal models of acute stroke has allowed the evaluation of mild and moderate hypothermia as a therapeutic modality in this clinical setting. Studies have demonstrated that animals subjected to hypothermia up to 3 hours after the primary central nervous system insult have reduced mortality and neuronal injury, and improved neurological outcome. These results warranted the evaluation of hypothermia in clinical trials. Even though hypothermia has potent neuroprotective effects in animal models of ischemic stroke, there are only a few clinical studies of therapeutic hypothermia in humans. Because of the small number of patients in the studies and the absence of matched controls, clinical studies are considered pilot studies for feasibility and safety. Thus, therapeutic hypothermia for ischemic stroke remains a promising but fiercely debated therapeutic modality. This review summarizes the animal model studies that have led to clinical trials in acute ischemic stroke. The existing techniques for inducing brain cooling, the mechanisms of neuroprotection, the complications of therapeutic hypothermia, and the future perspective of the field are also discussed.
急性中风动物模型的发展使得在这种临床环境中评估轻度和中度低温作为一种治疗方式成为可能。研究表明，在原发性中枢神经系统损伤后长达3小时接受低温治疗的动物死亡率降低、神经元损伤减少，神经功能结局得到改善。这些结果使得在临床试验中对低温治疗进行评估成为必要。尽管低温在缺血性中风动物模型中具有强大的神经保护作用，但在人类中进行治疗性低温的临床研究却很少。由于研究中的患者数量较少且缺乏匹配的对照组，临床研究被视为关于可行性和安全性的初步研究。因此，缺血性中风的治疗性低温仍然是一种有前景但备受激烈争议的治疗方式。本综述总结了那些促成急性缺血性中风临床试验的动物模型研究。还讨论了现有的诱导脑部降温的技术、神经保护机制、治疗性低温的并发症以及该领域的未来前景。
