Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
J Neurointerv Surg. 2017 Dec;9(12):1202-1207. doi: 10.1136/neurintsurg-2017-013197. Epub 2017 Jul 14.
Intracerebral hemorrhage and, more specifically, intraparenchymal hemorrhage, are devastating disease processes with poor clinical outcomes. Primary injury to the brain results from initial hematoma expansion while secondary hemorrhagic injury occurs from blood-derived products such as hemoglobin, heme, iron, and coagulation factors that overwhelm the brains natural defenses. Novel neuroprotective treatments have emerged that target primary and secondary mechanisms of injury. Nonetheless, translational application of neuroprotectants from preclinical to clinical studies has yet to show beneficial clinical outcomes. This review summarizes therapeutic agents and neuroprotectants in ongoing clinical trials aimed at targeting primary and secondary mechanisms of injury after intraparenchymal hemorrhage.
脑出血，更具体地说，脑实质内出血，是一种预后不良的破坏性疾病。大脑的原发性损伤是由初始血肿扩大引起的，而继发性出血性损伤则是由血液衍生的产物引起的，如血红蛋白、血红素、铁和凝血因子，这些产物超过了大脑的自然防御能力。目前已经出现了一些新的神经保护治疗方法，这些方法针对原发性和继发性损伤机制。尽管如此，神经保护剂从临床前研究到临床研究的转化应用尚未显示出有益的临床效果。本综述总结了目前正在进行的临床试验中用于治疗脑实质内出血后原发性和继发性损伤机制的治疗药物和神经保护剂。
