Xu Runnan, Wang Liping, Sun Liyuan, Dong Jianghui
Department of Guangxi Key Laboratory of Brain and Cognitive Neuroscience, Guilin Medical University, Guilin, Guangxi 541004, China.
College of Biotechnology, Guilin Medical University, Guilin, Guangxi 541100, China.
Life Sci. 2021 May 1;272:119257. doi: 10.1016/j.lfs.2021.119257. Epub 2021 Feb 22.
Ischemic encephalopathy is associated with a high mortality and rate of disability. The most common type of ischemic encephalopathy, ischemic stroke, is the second leading cause of death in the world. At present, the main treatment for ischemic stroke is to reopen blocked blood vessels. However, despite revascularization, many patients are not able to achieve good functional results. At the same time, the strict time window (<4.5 h) of thrombolytic therapy limits clinical application. Therefore, it is important to explore effective neuroprotective drugs for the treatment of ischemic stroke. Magnesium is a natural calcium antagonist, which exerts neuroprotective effects through various mechanisms. However, while most basic studies have shown that magnesium supplementation can help treat cerebral ischemia, intravenous magnesium supplementation in large clinical trials has failed to improve prognosis of ischemic patients. Therefore, we review the basic and clinical studies of magnesium supplementation for cerebral ischemia. According to the route of administration, treatment can be divided into intraperitoneal magnesium supplementation, intravenous magnesium supplementation, arterial magnesium supplementation and intracranial magnesium supplementation. We also summarized the potential influencing factors of magnesium ion intervention in cerebral ischemia injury. Finally, in combination with influencing factors derived from basic research, this article proposes three future research directions, including magnesium supplementation into the circulatory system combined with magnesium supplementation in the lateral ventricle, magnesium supplementation in the lateral ventricle combined with hypothermia therapy, and lateral ventricle magnesium supplementation combined with intracarotid magnesium supplementation combined with selective hypothermia.
缺血性脑病与高死亡率和致残率相关。缺血性脑病最常见的类型——缺血性中风，是全球第二大致死原因。目前，缺血性中风的主要治疗方法是重新开通阻塞的血管。然而，尽管进行了血管再通治疗，许多患者仍无法获得良好的功能恢复。同时，溶栓治疗严格的时间窗（<4.5小时）限制了其临床应用。因此，探索有效的神经保护药物来治疗缺血性中风具有重要意义。镁是一种天然的钙拮抗剂，可通过多种机制发挥神经保护作用。然而，虽然大多数基础研究表明补充镁有助于治疗脑缺血，但在大型临床试验中静脉补充镁未能改善缺血患者的预后。因此，我们综述了补充镁治疗脑缺血的基础和临床研究。根据给药途径，治疗可分为腹腔内补镁、静脉补镁、动脉补镁和颅内补镁。我们还总结了镁离子干预脑缺血损伤的潜在影响因素。最后，结合基础研究得出的影响因素，本文提出了三个未来的研究方向，包括循环系统补镁联合侧脑室补镁、侧脑室补镁联合低温治疗、侧脑室补镁联合颈内动脉补镁并选择性低温。
