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中风后周围器官损伤

Peripheral Organ Injury After Stroke.

作者信息

Wang Jin, Zhang Jiehua, Ye Yingze, Xu Qingxue, Li Yina, Feng Shi, Xiong Xiaoxing, Jian Zhihong, Gu Lijuan

机构信息

Central Laboratory, Renmin Hospital of Wuhan University, Wuhan, China.

Department of Anesthesia, Renmin Hospital of Wuhan University, Wuhan, China.

出版信息

Front Immunol. 2022 Jun 1;13:901209. doi: 10.3389/fimmu.2022.901209. eCollection 2022.

Abstract

Stroke is a disease with high incidence, mortality and disability rates. It is also the main cause of adult disability in developed countries. Stroke is often caused by small emboli on the inner wall of the blood vessels supplying the brain, which can lead to arterial embolism, and can also be caused by cerebrovascular or thrombotic bleeding. With the exception of recombinant tissue plasminogen activator (rt-PA), which is a thrombolytic drug used to recanalize the occluded artery, most treatments have been demonstrated to be ineffective. Stroke can also induce peripheral organ damage. Most stroke patients have different degrees of injury to one or more organs, including the lung, heart, kidney, spleen, gastrointestinal tract and so on. In the acute phase of stroke, severe inflammation occurs in the brain, but there is strong immunosuppression in the peripheral organs, which greatly increases the risk of peripheral organ infection and aggravates organ damage. Nonneurological complications of stroke can affect treatment and prognosis, may cause serious short-term and long-term consequences and are associated with prolonged hospitalization and increased mortality. Many of these complications are preventable, and their adverse effects can be effectively mitigated by early detection and appropriate treatment with various medical measures. This article reviews the pathophysiological mechanism, clinical manifestations and treatment of peripheral organ injury after stroke.

摘要

中风是一种发病率、死亡率和致残率都很高的疾病。它也是发达国家成年人残疾的主要原因。中风通常是由供应大脑的血管内壁上的小栓子引起的,这会导致动脉栓塞,也可能由脑血管出血或血栓形成出血引起。除了用于使闭塞动脉再通的溶栓药物重组组织型纤溶酶原激活剂(rt-PA)外,大多数治疗方法已被证明无效。中风还可诱发外周器官损伤。大多数中风患者的一个或多个器官会受到不同程度的损伤,包括肺、心脏、肾脏、脾脏、胃肠道等。在中风急性期,大脑会发生严重炎症,但外周器官存在强烈的免疫抑制,这大大增加了外周器官感染的风险并加重了器官损伤。中风的非神经并发症会影响治疗和预后,可能导致严重的短期和长期后果,并与住院时间延长和死亡率增加有关。其中许多并发症是可以预防的,通过早期发现并采取各种医疗措施进行适当治疗,可以有效减轻它们的不良影响。本文综述了中风后外周器官损伤的病理生理机制、临床表现及治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c41a/9200619/0d94380ee8b1/fimmu-13-901209-g001.jpg

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