Ischemic penumbra - The therapeutic window
Ischemic penumbra - The therapeutic window
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DOI：
10.1212/wnl.51.3_suppl_3.s44
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发表时间：
1998-09-01
期刊：
影响因子：
9.9
通讯作者：
Hakim, AM
中科院分区：
文献类型：
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作者：
Hakim, AM
缺血半暗带的概念扩展了我们对局灶性缺血过程的理解，并在许多方面振兴了我们的研究。简而言之，半影是大脑的一部分，夹在即将死亡的大脑区域和接受足够血液进行交流的大脑区域之间。因此，缺血的脑组织只有足够的能量来维持短时间内的生存；不足以沟通和发挥作用。半影的预期寿命很短。尽管半影是一个优雅的概念，但在实践中却很难利用。一方面，它在时间和空间上都不稳定。根据局灶性缺血的严重程度和持续时间，它可能位于缺血性大脑的任何地方。我们相信尼莫地平结合实验让我们了解了很多关于缺血半暗带的知识。其次，半暗带中的细胞可能不是因坏死而死亡，而是因细胞凋亡而死亡。如果这是真的，那么我们关于良性短暂性脑缺血发作的概念可能需要修改。第三，半影不仅可以通过再灌注，还可以通过中断细胞凋亡的过程来恢复其生存能力。
The concept of ischemic penumbra has extended our understanding of the focal ischemic process and in many ways has revitalized our research. Simply stated, the penumbra is the part of the brain that is sandwiched between brain regions committed to die and those that receive enough blood to communicate. Therefore, it is ischemic brain tissue that has just enough energy to survive for a short time but; not enough to communicate and function. The life expectancy of the penumbra is short. Although the penumbra is an elegant concept, in practice it has been a difficult one to exploit. For one thing, it is unstable in both time and space. Depending on the severity and the duration of the focal ischemia, it may be anywhere in the ischemic brain. We believe that nimodipine binding experiments have taught us a great deal about the ischemic penumbra. Second, cells in the penumbra may die not by necrosis but by apoptosis. If that is true, then our concepts about the benign transient ischemic attack may need revision. Third, the penumbra may regain its ability to survive not only through reperfusion but also by interrupting the process of commitment to apoptosis.