Departments of Pathology, University of Miami School of Medicine, PO Box 016960, Miami, FL 33101, USA.
Metab Brain Dis. 2010 Mar;25(1):97-106. doi: 10.1007/s11011-010-9175-0. Epub 2010 Feb 25.
Central pontine myelinolysis (CPM) is a demyelinating condition affecting not only the pontine base, but also involving other brain areas. It usually occurs on a background of chronic systemic illness, and is commonly observed in individuals with alcoholism, malnutrition and liver disease. Studies carried out 25-30 years ago established that the principal etiological factor was the rapid correction of hyponatremia resulting in osmotic stress. This article reviews progress achieved since that time on its pathogenesis, focusing on the role of organic osmolytes, the blood-brain, barrier, endothelial cells, myelinotoxic factors triggered by osmotic stress, and the role of various factors that predispose to the development of CPM. These advances show great promise in providing novel therapeutic options for the management of patients afflicted with CPM.
脑桥中央髓鞘溶解症（CPM）是一种脱髓鞘疾病，不仅影响脑桥基底，还涉及其他脑区。它通常发生在慢性全身性疾病的背景下，在酗酒、营养不良和肝脏疾病患者中较为常见。25-30 年前进行的研究表明，主要的病因是低钠血症的快速纠正导致渗透压应激。本文综述了自那时以来在其发病机制方面取得的进展，重点介绍了有机渗透物、血脑屏障、内皮细胞、渗透压应激引发的髓鞘毒性因子的作用，以及各种易患 CPM 发展的因素的作用。这些进展为治疗患有 CPM 的患者提供了新的治疗选择，具有广阔的前景。
