Samoilova E M, Yusubalieva G M, Belopasov V V, Ekusheva E V, Baklaushev V P
Federal Scientific and Clinical Center of Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency of Russia, Moscow, Russia.
Astrakhan State Medical University, Astrakhan, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(8. Vyp. 2):11-21. doi: 10.17116/jnevro202112108211.
The review systematizes data on the role of infectious diseases and systemic inflammation in the pathogenesis of stroke. Various risk factors for stroke associated with pro-inflammatory reactions and their contribution to the pathogenesis of cerebrovascular pathology are analyzed. The interaction of systemic inflammation with hemostasis disturbances and clots formation, activation of autoreactive clones of cytotoxic lymphocytes, the progression of endothelial damage, and other processes is shown. Along with infection, these factors increase the risk of stroke. The key mechanisms of the pathogenesis from the development of acute or chronic inflammation to the preconditions of stroke are presented. The mechanisms of the acting of the infectious process as a trigger factor and/or medium-term or long-term risk factors of stroke are described. A separate section is devoted to the mechanisms of developing cerebrovascular diseases after COVID-19. Identifying an increased risk of stroke due to infection can be of great preventive value. Understanding of this risk by specialists followed by correction of drug therapy and rehabilitation measures can reduce the incidence of cerebrovascular complications in infectious patients.
该综述对传染病和全身炎症在中风发病机制中的作用数据进行了系统化整理。分析了与促炎反应相关的各种中风危险因素及其对脑血管病变发病机制的影响。展示了全身炎症与止血障碍和血栓形成、细胞毒性淋巴细胞自身反应性克隆的激活、内皮损伤的进展以及其他过程之间的相互作用。除感染外,这些因素会增加中风风险。阐述了从中风发病机制的关键机制,从急性或慢性炎症的发展到中风的前提条件。描述了感染过程作为中风触发因素和/或中期或长期危险因素的作用机制。单独的一部分专门探讨了新冠病毒感染后脑血管疾病的发病机制。识别出因感染导致的中风风险增加具有重要的预防价值。专家了解这种风险后,对药物治疗和康复措施进行调整,可降低感染患者脑血管并发症的发生率。