缺血性脑卒中作为全球发病率、致残率最高的疾病之一。其会引起中枢神经系统功能障碍、神经炎症和神经元死亡等一系列病理生理改变,临床预后较差。长非编码RNA (LncRNA)作为非编码RNA家族中的一员,近些年在肿瘤、心血管疾病和神经退行性疾病等领域成为研究的热点。近期通过对缺血性卒中的细胞、动物模型以及临床患者的样本进行测序分析,均发现它们的LncRNA转录谱存在显著差异。进一步研究表明,表达异常的LncRNA参与了缺血性卒中引发的细胞凋亡、细胞自噬、免疫炎症、氧化应激以及血管生成等病理生理过程,并通过不同层面的调控机制对卒中的预后产生正面或负面的影响。本文将对LncRNA转录前后调控等机制进行探讨,以阐明LncRNA调控链与缺血性卒中转归之间的关系,为缺血性卒中患者治疗提供新的思路。Ischemic stroke, a global leader in both incidence and disability rates, triggers a cascade of pathological changes within the central nervous system: dysfunction, neuroinflammation, and neuronal loss, frequently accompanied by bleak prognoses. Among the non-coding RNA family, long non-coding RNAs (LncRNAs) have lately captivated scientific interest across disciplines like oncology, cardiovascular diseases, and neurodegeneration. Recent sequencing endeavors in cellular models, animal studies, and actual ischemic stroke patient samples have unveiled marked discrepancies in LncRNA expression patterns. Advancing these findings, it’s been elucidated that dysregulated LncRNAs are embroiled in the intricate mechanisms following stroke, such as cell death, autophagy, immune responses, and vascular formation, influencing recovery either detrimentally or beneficially through multifaceted regulatory pathways. This discourse delves into the intricacies of LncRNA modulation—genetic, transcriptional, and post-transcriptional—to illuminate how this regulatory network intersects with stroke outcom
目的通过观察开颅术后颅内压数值,及时发现患者病情变化,为下一步治疗提供客观依据。方法收集绍兴市人民医院2013年4月到2015年10月在本院开颅手术病例248例,分为两组。一组124例患者术后行有创颅内压监测;另一组124例患者作为对照组,开颅术后未行颅内压监测。观察患者住院期间并发症发生率,以电介质紊乱、急性肾功能衰竭、肺部感染为评价指标。再对患者进行6个月的随访,根据患者日常生活能力(Activitics of daily living,ADL)分级法进行评价。结果监测组电介质紊乱发生48例,对照组发生78例;急性肾功能衰竭监测组发生2例,对照组为9例;肺部感染监测组发生28例,对照组发生35例。统计学上均有明显差异(P<0.05)。监测组恢复良好者90例,良好率72.58%;对照组恢复良好者67例,良好率54.03%。两组差异有统计学意义。结论颅内压监测可以及时发现病情变化,指导术后用药,可以减少术后并发症,提高患者日常生活能力。
