国际麻醉学与复苏杂志   2024, Issue (11): 0-0
    
心脏骤停复苏后脑神经元死亡机制研究进展
徐若彤, 高昌俊1()
1.空军军医大学基础医学院学员三大队
Research progress on the mechanism of brain neuron death after cardiac arrest resuscitation
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摘要:

心脏骤停患者复苏后常遗留不同程度的神经系统功能障碍,脑神经元的大量死亡是造成复苏后脑损伤的重要原因,传统研究表明,坏死和凋亡是复苏后脑神经元死亡的主要方式,但随着细胞死亡机制研究的推进,人们发现,复苏后的神经元还可能通过铁死亡、焦亡、坏死性凋亡、泛凋亡及自噬等形式死亡。本文综述了心脏骤停及复苏后可能存在的神经元死亡途径,对神经元死亡途径的充分理解将有助于在一定的级联反应中针对不同的步骤加以干预,从而延缓细胞死亡或挽救功能失调的神经元,对于减少神经系统后遗症发生率具有重要意义。此外,本文还讨论了各种神经元死亡方式相关抑制药物的应用前景,以期为复苏后脑保护提供更多理论参考。

关键词: 心脏骤停;心肺复苏;铁死亡;焦亡;坏死性凋亡;自噬
Abstract:

After resuscitation, patients with cardiac arrest often experience varying degrees of neurological dysfunction, and a significant number of neuronal deaths in the brain contribute to post-resuscitation brain injury. Traditional studies have indicated that necrosis and apoptosis are the primary mechanisms of neuronal death following resuscitation. However, as research on cell death mechanisms advances, it has been discovered that resuscitated neurons can also undergo Ferroptosis, Pyroptosis, Necroptosis and Autophagy. This paper provides an overview of potential pathways leading to neuronal death after cardiac arrest and resuscitation. A comprehensive understanding of these pathways will facilitate intervention at different stages within specific cascade reactions to delay cell death or rescue dysfunctional neurons. This is crucial for reducing the incidence of neurological sequelae. Furthermore, this paper discusses the potential application prospects of various inhibitors related to neuronal death in order to provide theoretical references for brain protection after resuscitation.

Key words: Cardiac arrest; Cardiopulmonary resuscitation; Ferroptosis; Pyroptosis; Necroptosis; Autophagy