Rehncrona S
Acta Neurochir Suppl (Wien). 1986;36:125-8. doi: 10.1007/978-3-7091-8859-0_34.
Multiple factors are responsible for the development of irreversible cell damage in the ischemic brain. Different molecular mechanisms may operate alone or may influence each other to create a vicious circle leading to a point of no-return. Tissue energy failure, disruption of ionic homeostasis, and severe tissue lactic acidosis can be regarded as major basic mechanisms that provoke a sequence of events finally leading to degradation and death of brain cells. Accumulation of calcium, liberation of free fatty acids, and pathologic free radical reactions during the postischemic phase may have additional pathogenetic significance. Possibilities to protect the ischemic brain are discussed with respect to the different pathogenetic mechanisms. Primarily, these include measures taken to decrease the cerebral energy demands and to prevent the development of severe tissue lactic acidosis.
多种因素导致缺血性脑损伤发展为不可逆性细胞损伤。不同的分子机制可能单独起作用，也可能相互影响形成恶性循环，导致无法挽回的局面。组织能量衰竭、离子稳态破坏和严重的组织乳酸酸中毒可被视为引发一系列最终导致脑细胞降解和死亡事件的主要基本机制。缺血后阶段钙的积累、游离脂肪酸的释放以及病理性自由基反应可能具有额外的致病意义。针对不同的致病机制，讨论了保护缺血性脑的可能性。主要措施包括采取措施降低脑能量需求并预防严重组织乳酸酸中毒的发生。
