.至!f、医生塾些萱丛痼盆』f~;唑l,牛!旦盟!鲞望!型j:减少致残率,促进功能最大限度的恢复。4结语脑缺血后的组织损害是多因素参与、多途径进行的复杂病理过程,在治疗上除r尽可能恢复有效的灌注外.采用多种神经保护治疗有助于减轻损伤和减少后遗症目前脑缺fI『|的脑保护剂研究取得了K足的进展.但仍存在许多问题亟待解决,如:(1)联合治疗的可行性如何,溶栓+抗必台毒性/抗自由基治疗能否取得更好疗效;(2)抑制凋亡是否挽救了无功能的神经元,抑制炎症反应是否损害正常的生理过程;(3)人类是否存在梗死区周围去极化现象;(4)炎症、凋亡在卒巾发病巾的重要性究竟如何;(5)新的MRI或视觉成像技术足否有助于判断病理阶段以及定量评价缺血组织的恢复情况等。对ji治疗腩梗死临床|ji_『期或临床应用试验,不仅有助于寻找有效的治疗药物,也可促进对其发病机制的进一步认识,从而取得临床治疗的突破性进展。参考文献TavimTN.DavisP卜LTomerJC.elalLi佬timeCOStofstrokcinthcUnledSlatesScroke.】996,27f9,:1459-1466.二delZoppoG』C陆raltrmbmacuEestroke:whyhavelheynotbeensuccess如17Neurobgy,1998.51(3Suppl3)s59-6】3LeesKROerestatandotherNMIDAantagOlllSIsm证cherniostrokeNeuroio吖199749(5Suppl4):S66-6947agayaMLiuKF.CopelandB.e1.alDNAscssnnafterfocalbrahischemiaTemgoraldiffefet-tcesintwospecksS【roke、1997、28(6)】245-1254.5FurukawaKFuW.LiHetalTheactinseveringproteingekoh139moduhatescalcinmchanne】andNMDAreceptor.1rtl、lI”㈨dvulnerabditytoexcRotoxlclty113h”pocanlpalncuronsJ、cumsc997.】7(211:8178—8】866ChenZL.StriokhndSNeuronaldeathinthehinpocampus6promotedbyphsmin—catalyzeddegradalionolkn㈧Cell19979lr71917母25.7HossmannK/LPer曲farctdeDoJafEat㈨CerebreⅦcBrainMembR盯.1996.8f3、195—2098Bakd蛆PenileldASchlaugG,etaLEnlargementolhumancerebra】ischemio]esionvolumesmeasuredbydifthsion—weightediiiag—neticresoB3/lceimagingAnnN6,u[oL19974¨51。58】_5引9O’NelllL^-KaltschmidtCNFkappaRacrucial[rmlscripti,1nfactorforgKaIandneHronRlcellfuFIetiontrendsNeurosci199720f6l。252-25810甑ceAJ踟lingW.KmdyMS.etalAlteredBeurofllllandmlcroghafresponsebEDexcilotoxicand8cb,emicbr趣,日lⅣninmicelack血gTNFreceptorsNatMed,1996.2(7):788-7941lMurakmnlkKondoT.KawascM.既alMtochondrtalsuscepttbflllYtooxidatwesⅡtssexacerbatescerebralmfarctionthattollowspert[1arlentfoc“ecrcbr础isehemiainmll[爿tll[micewithmmlgancscsuperoxidedismutasedc血JencyJNcurosck1998.18f¨205-2l312IadecolaC.日ightanddarkskicsofnin"iooxide㈣hcm℃braininjuryTrendsNeurosei.1997.20f31:132一【3913Kaufmmm蛳FⅡ1kADFuh|1慨吼“IocI、em记cn代andpc-numbrainhumanstrokeStroke】999,30f11939914TurskiL}ILtthASheardownM.etalZK200775aphosphonatequinoxahedione川PAanmgonistfbrneuroprotec[10nitlr;irokcandtraumaProcNatlAcadSclUS气1998,95(18】.】0960-1096515B0nd丸O‘NeiilMJ.HicksCA,etakNeuro口rolecIⅣeeffd:tsofasystemicallyactivegroup11metabotropioghtamatereceptoragonistLY354740hagerbilmodelofglobal“chaemmNeuroreport19989f6、11射-1193.16LeistM,NiooteraPApoptosis,excitotoxioI【y,andneuropathoiogyExp&ⅡRes,1998,239(2)183-20l17ThomberryNALazebnmYCaspases:eBemleswnhmSc#rlce.1998.28l(538¨+1312-I31618NarrlttraS.丑1uJ.FinkKctatActivationandcbageofcasp“se-3mapoptosisinducedbyexperimentalcerebralischemtajNeuroscL1998.18(10):3659-3668(收稿:2000-12-25修州:2001.q224)褪黑色素的脑保护作用顾海蓉王国权赵瑛D1n』\阿卜1摘要褪黑素是由松果体合成的重要神经内分泌激素之一,具有很强的自由基清除作用和神经保护作用新近的研究表明.褪黑索还可特异性地对抗p一淀粉样蛋白的毒性作用,延缓Alzhcimer病神...