高渗盐水治疗脑水肿和颅高压的机制
首发时间:2014-02-21
摘要:高渗溶液是减轻脑水肿、降低颅高压最常用的治疗措施。随着对高渗盐水(hypertonic saline,HTS) 治疗脑水肿和颅高压研究的深入,HTS展现出不同于甘露醇高渗溶液治疗脑水肿和颅高压的作用优势。HTS治疗脑水肿的机制并未完全阐明,其可能的治疗机制涉及渗透性作用、以及改善脑组织灌流、抑制炎症反应、下调水通道蛋白4的表达和促进谷氨酸神经递质回收等多种非渗透机制。
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Mechanisms of hypertonic saline solutions in treatment of cerebral edema and intracranial hypertension
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.
Keywords: cerebral edema;hypertonic saline;mannitol;ntracranial hypertension
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