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      高滲鹽水治療腦水腫和顱高壓的機制
      來源: | 作者: | 發布時間:2014-4-15 14:35:39

      高滲鹽水治療腦水腫和顱高壓的機制
      羅自強1,岳少杰2,余小河2
      基金項目:高等學校博士學科點專項科研基金資助課題(20090162110016);國家自然科學基金金資助課題(81070970) 作者簡介:羅自強(1962年-),男,教授,主要研究方向:呼吸生理和腦損傷保護.

      (1. 中南大學基礎醫學院生理學系,長沙 410013; 2. 中南大學湘雅醫院新生兒科,長沙 410008)
      摘要:高滲溶液是減輕腦水腫、降低顱高壓最常用的治療措施。隨著對高滲鹽水(hypertonic saline,HTS) 治療腦水腫和顱高壓研究的深入,HTS展現出不同于甘露醇高滲溶液治療腦水腫和顱高壓的作用優勢。HTS治療腦水腫的機制并未完全闡明,其可能的治療機制涉及滲透性作用、以及改善腦組織灌流、抑制炎癥反應、下調水通道蛋白4的表達和促進谷氨酸神經遞質回收等多種非滲透機制。
      關鍵詞:腦水腫;高滲鹽水;甘露醇;顱高壓
      中圖分類號:R651
      Mechanisms of hypertonic saline solutions in treatment of 15 cerebral edema and intracranial hypertension
      LUO Ziqiang1, YUE Shaojie2, YU Xiaohe2
      (1. Department of phsiology,Xiangya school of medicine,Central South University,Changsha 410013; 2. Department of Neonatology,Xiangya hospital,Central South University,Changsha,410008)

      Abstract: Hypertonic solution has been the mainstay therapy in clinical practice for the treatment of cerebral edema and intracranial hypertension. Many experimental and clinical studies regarding the use of hypertonic saline (HTS) have suggested that HTS is superior to mannitol in cerebral edema treatment and intracranial pressure reduction. The mechanisms of action of HTS for treatment of cerebral edema, however, have not been fully demonstrated. The possible  mechanisms of action of HTS are the osmotic effect and non-osmotic effect. The non-osmotic mechanisms include the improvement of the cerebral blood flow, the inhibition of inflammatory reaction, the down-regulation of the aquaporin 4 expression and the promotion of the glutamate neurotransmitter recycling.
      Key words: cerebral edema;hypertonic saline;mannitol;ntracranial hypertension

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