Program in Trauma Department of Neurology University of Maryland School of Medicine,Baltimore MD USA.
Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA.
Expert Opin Pharmacother. 2021 Jun;22(8):1025-1037. doi: 10.1080/14656566.2021.1876663. Epub 2021 Jan 27.
: Cerebral edema is a common complication of multiple neurological diseases and is a strong predictor of outcome, especially in traumatic brain injury and large hemispheric infarction.: Traditional and current treatments of cerebral edema include treatment with osmotherapy or decompressive craniectomy at the time of clinical deterioration. The authors discuss preclinical and clinical models of a variety of neurological disease states that have identified receptors, ion transporters, and channels involved in the development of cerebral edema as well as modulation of these receptors with promising agents.: Further study is needed on the safety and efficacy of the agents discussed. IV glibenclamide has shown promise in preclinical and clinical trials of cerebral edema in large hemispheric infarct and traumatic brain injury. Consideration of underlying pathophysiology and pharmacodynamics is vital, as the synergistic use of agents has the potential to drastically mitigate cerebral edema and secondary brain injury thusly transforming our treatment paradigms.
脑水肿是多种神经疾病的常见并发症，是预后的一个重要预测因素，特别是在创伤性脑损伤和大面积半球梗死中。传统和当前的脑水肿治疗方法包括在临床恶化时进行渗透性治疗或去骨瓣减压术。作者讨论了各种神经疾病状态的临床前和临床模型，这些模型确定了与脑水肿发展有关的受体、离子转运体和通道，以及用有前途的药物对这些受体的调节。需要进一步研究所讨论药物的安全性和疗效。IV 格列本脲在大面积半球梗死和创伤性脑损伤的脑水肿的临床前和临床试验中显示出了希望。考虑潜在的病理生理学和药效学是至关重要的，因为联合使用这些药物有可能极大地减轻脑水肿和继发性脑损伤，从而改变我们的治疗模式。
