ICH的治疗 - 安则诺医药

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阿尔伯特 · 爱因斯坦 (1879-1955)

出血性脑卒中约占脑卒中总数的 13%，是由脑出血（ICH）或蛛网膜下腔出血（SAH）引起的[1,2]。在西方人群中，脑出血（ICH）约占所有脑卒中的 10%，在亚洲人群中占 20-30% [1,3,4,8]。

脑出血（ICH）是最致命的中风亚型，具有高致残率和高死亡率[4,5,8]。迄今为止，还没有任何干预措施在改善预后方面显示出明显的疗效[3,6,10]。

目前脑出血（ICH）的治疗侧重于通过降低血压、逆转抗凝治疗或清除血肿来限制血肿体积[7,9]。然而，在过去的几十年里，ICH后的治疗效果并未改善[8]。目前很少有循证治疗方法，导致临床虚无主义态度，包括早期姑息治疗[8]。

参考文献

Khattar NK, Williams BJ, Ding D, et al. Chapter 22 Neuroprotective Strategies in Hemorrhagic Stroke. In: Lapchak PA, YANG GY, editors. Translational Research in Stroke. Singapore: Springer Singapore, 2017. P492.
Xu R, Gjpro A, Schneider UC, et al. Chapter 13 Microglia Function in Stroke. In: Lapchak PA, YANG GY, editors. Translational Research in Stroke. Singapore: Springer Singapore, 2017. P281.
Greenberg SM, Ziai WC, Cordonnier C, et al. 2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association. Stroke 2022; 53(7): e282-e361.
Xiao L, Zheng H, Li J, Wang Q, et al. Neuroinflammation Mediated by NLRP3 Inflammasome After Intracerebral Hemorrhage and Potential Therapeutic Targets. Mol Neurobiol. 2020; 57(12): 5130-5149.
Li J, Xiao L, He D, et al. Mechanism of White Matter Injury and Promising Therapeutic Strategies of MSCs After Intracerebral Hemorrhage. Front Aging Neurosci. 2021; 13: 632054.
Ganesh Kumar N, Zuckerman SL, Khan IS, et al. Treatment of intracerebral hemorrhage: a selective review and future directions. J Neurosurg Sci. 2017; 61(5): 523-535.
Ramadhan MIA, Sitanaya SN, Hakim AHW, et al. The Role of Iron-Chelating Therapy in Improving Neurological Outcome in Patients with Intracerebral Hemorrhage: Evidence-Based Case Report. Medicina (Kaunas). 2023; 59(3): 453.
Hostettler IC, Seiffge DJ, Werring DJ. Intracerebral hemorrhage: an update on diagnosis and treatment. Expert Rev Neurother. 2019; 19(7): 679-694.
Reyes R, Viswanathan M, Aiyagari V. An update on neurocritical care for intracerebral hemorrhage. Expert Rev Neurother. 2019; 19(6): 557-578.
Sembill JA, Kuramatsu JB. Akutbehandlung der intrazerebralen Blutung [Acute treatment of intracerebral hemorrhage]. Med Klin Intensivmed Notfmed. 2019; 114(7): 613-619.

出血性脑卒中约占脑卒中总数的 13%，是由脑出血（ICH）或蛛网膜下腔出血（SAH）引起的[1,2]。在西方人群中，脑出血（ICH）约占所有脑卒中的 10%，在亚洲人群中占 20-30% [1,3,4,8]。

脑出血（ICH）是最致命的中风亚型，具有高致残率和高死亡率[4,5,8]。迄今为止，还没有任何干预措施在改善预后方面显示出明显的疗效[3,6,10]。

目前脑出血（ICH）的治疗侧重于通过降低血压、逆转抗凝治疗或清除血肿来限制血肿体积[7,9]。然而，在过去的几十年里，ICH后的治疗效果并未改善[8]。目前很少有循证治疗方法，导致临床虚无主义态度，包括早期姑息治疗[8]。

参考文献

Khattar NK, Williams BJ, Ding D, et al. Chapter 22 Neuroprotective Strategies in Hemorrhagic Stroke. In: Lapchak PA, YANG GY, editors. Translational Research in Stroke. Singapore: Springer Singapore, 2017. P492.

Xu R, Gjpro A, Schneider UC, et al. Chapter 13 Microglia Function in Stroke. In: Lapchak PA, YANG GY, editors. Translational Research in Stroke. Singapore: Springer Singapore, 2017. P281.

Greenberg SM, Ziai WC, Cordonnier C, et al. 2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association. Stroke 2022; 53(7): e282-e361.

Xiao L, Zheng H, Li J, Wang Q, et al. Neuroinflammation Mediated by NLRP3 Inflammasome After Intracerebral Hemorrhage and Potential Therapeutic Targets. Mol Neurobiol. 2020; 57(12): 5130-5149.

Li J, Xiao L, He D, et al. Mechanism of White Matter Injury and Promising Therapeutic Strategies of MSCs After Intracerebral Hemorrhage. Front Aging Neurosci. 2021; 13: 632054.

Ganesh Kumar N, Zuckerman SL, Khan IS, et al. Treatment of intracerebral hemorrhage: a selective review and future directions. J Neurosurg Sci. 2017; 61(5): 523-535.

Ramadhan MIA, Sitanaya SN, Hakim AHW, et al. The Role of Iron-Chelating Therapy in Improving Neurological Outcome in Patients with Intracerebral Hemorrhage: Evidence-Based Case Report. Medicina (Kaunas). 2023; 59(3): 453.

Hostettler IC, Seiffge DJ, Werring DJ. Intracerebral hemorrhage: an update on diagnosis and treatment. Expert Rev Neurother. 2019; 19(7): 679-694.

Reyes R, Viswanathan M, Aiyagari V. An update on neurocritical care for intracerebral hemorrhage. Expert Rev Neurother. 2019; 19(6): 557-578.

Sembill JA, Kuramatsu JB. Akutbehandlung der intrazerebralen Blutung [Acute treatment of intracerebral hemorrhage]. Med Klin Intensivmed Notfmed. 2019; 114(7): 613-619.