急性缺血性中风的治疗性低温:从临床前研究到临床试验
Xi Chen1, Jin Xu2, Jiachen He1,3
1Department of Neurology and China-America Institute of Neuroscience, Xuanwu Hospital, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, 100053, China.
Science China. Life sciences
|June 3, 2025
概括
治疗性低温 (TH) 显示出急性缺血性中风 (AIS) 的前景. 优化TH需要精确控制大脑温度,启动时间和持续时间,以获得更好的临床转换.
科学领域:
- 神经科学是一个神经科学.
- 神经学 神经学
- 临界护理医学 临界护理医学
背景情况:
- 治疗性低温 (TH) 是一种公认的神经保护策略.
- 对于急性缺血性中风 (AIS) 的TH的临床应用产生了不同的结果.
- 在AIS的TH实验和临床研究之间存在差异.
研究的目的:
- 审查关于缺血性中风低温的原始研究.
- 在AIS管理中确定优化TH的关键参数.
- 为了弥合TH的台和床边应用之间的差距.
主要方法:
- 在PubMed,科学网,Embase和奥维德医学 (1990-2023) 的综合文献搜索.
- 在严格选后包括304项原始研究,并排除不相关的研究.
- 分析研究参数,包括低温应用的深度,持续时间和时间.
主要成果:
- 在实验和临床环境之间观察到低温深度,持续时间和开始延迟的显著差异.
- 介绍关键概念:"实际大脑温度"",低温开始时间"和"有效低温持续时间".
- 在AIS中临床TH的推参数:34-35°C,2-4小时的持续时间,立即启动和自然回暖.
结论:
- 对于AIS的TH临床翻译需要对关键参数进行标准化.
- 选择性脑冷却在再注射治疗期间是建议的.
- 需要进一步的研究来提高TH疗效和对AIS治疗的理解.
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