Strategies for neuroprotection following spinal cord injury.
Strategies for neuroprotection following spinal cord injury.
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发表时间：
2009-03
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通讯作者：
P. Tederko;M. Krasuski;J. Kiwerski;Izabela Nyka;D. Białoszewski
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作者：
P. Tederko;M. Krasuski;J. Kiwerski;Izabela Nyka;D. Białoszewski
神经病理学的进展使描述创伤性脊髓损伤（SCI）后早期神经组织的局部反应成为可能。最近确定的继发性脊髓损伤和潜在的再生能力的多个因素还没有导致在SCI患者的神经保护治疗的标准的发展。本文回顾了目前的知识有关的顺序在受伤的脊髓生化事件，并概述了治疗的可能性，以防止继发性损伤的蔓延。通过文献调研，得出以下结论：1.创伤性损伤的原发区域由于局部血管紊乱、缺氧和由此产生的炎症而扩大。2.继发性损伤区域的炎症除了具有破坏性影响外，还是可能诱导神经组织修复的物质的来源。3.脊髓损伤后数小时内给予甲基强的松龙和脊髓减压术可改善不完全神经功能缺损患者的功能和神经功能结局。目前还没有足够的科学证据支持其他神经保护方法在人类中的安全性和有效性。
Progress in neuropathology has made possible the description of local responses of neural tissue in early stages after traumatic spinal cord injury (SCI). The recent identification of multiple factors responsible for secondary spinal cord damage and for potential regenerative abilities has not resulted in the development of a standard for neuroprotective therapy in SCI patients. The paper reviews current knowledge concerning the sequence of biochemical events in the injured spinal cord and gives an overview of therapeutic possibilities for preventing the spread of secondary injury. The literature survey has led to the following conclusions: 1. The primary zone of traumatic damage enlarges due to local vascular disturbances, hypoxia, and the resulting inflammation. 2. Inflammation in the region of secondary injury, apart from having a destructive impact, is the source of substances which may induce neural tissue repair. 3. The administration of methylprednisolone and surgical decompression of the spinal cord within several hours after SCI improves functional and neurological outcomes in patients with incomplete neurological deficits. Currently there is no sufficient scientific evidence to support the safety and efficacy of other neuroprotective methods in humans.