School of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355.
Department of Rehabilitation Medicine, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250001, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Mar 28;49(3):447-456. doi: 10.11817/j.issn.1672-7347.2024.230427.
Ischemic stroke (IS) is a severe cerebrovascular disease that seriously endangers human health. Gut microbiota plays a key role as an intermediate mediator in bidirectional regulation between the brain and the intestine. In recent years, trimethylamine N-oxide (TMAO) as a gut microbiota metabolite has received widespread attention in cardiovascular diseases. Elevated levels of TMAO may increase the risk of IS by affecting IS risk factors such as atherosclerosis, atrial fibrillation, hypertension, and type 2 diabetes. TMAO exacerbates neurological damage in IS patients, increases the risk of IS recurrence, and is an independent predictor of post-stroke cognitive impairment (PSCI) in patients. Current research suggests that the mechanisms of TMAO action include endothelial dysfunction, promoting of foam cell formation, influence on cholesterol metabolism, and enhancement of platelet reactivity. Lowering plasma TMAO levels through the rational use of traditional Chinese medicine, dietary management, vitamins, and probiotics can prevent and treat IS.
缺血性脑卒中（IS）是一种严重危害人类健康的脑血管疾病。肠道微生物群作为脑肠双向调节的中间介质起着关键作用。近年来，三甲基胺 N-氧化物（TMAO）作为一种肠道微生物群代谢物，在心血管疾病中受到广泛关注。TMAO 水平升高可能通过影响动脉粥样硬化、心房颤动、高血压和 2 型糖尿病等 IS 危险因素，增加 IS 的风险。TMAO 可加重 IS 患者的神经损伤，增加 IS 复发风险，是患者卒中后认知障碍（PSCI）的独立预测因子。目前的研究表明，TMAO 的作用机制包括内皮功能障碍、促进泡沫细胞形成、影响胆固醇代谢以及增强血小板反应性。通过合理使用中药、饮食管理、维生素和益生菌降低血浆 TMAO 水平，可以预防和治疗 IS。
