缺血性脑卒中：从机制到治疗(综述)

Ischemic Stroke: Mechanisms to Treatment (Review)

摘要: 缺血性脑卒中是全球最常见的脑卒中类型，严重影响全球人口尤其是在老年人群中的健康和经济状态。目前，紧急治疗主要依赖于在病发初期使用特定药物进行溶栓，以及利用机械取栓技术扩展治疗时间窗口。尽管这些方法提高了治疗的及时性和效果，但仍有许多挑战需要克服，特别是在治疗策略的优化和个性化治疗方面。最新的研究表明，遗传因素和免疫微环境在缺血性脑卒中的发生和发展中扮演着关键角色。这些因素的深入了解不仅可以帮助医学界更好地理解脑卒中的复杂病理机制，还能推动发展更为精准的治疗方法。研究指出，特定的遗传背景对脑卒中的风险有显著影响，而患者的免疫状态也在脑卒中的损伤和恢复过程中起着至关重要的作用。因此，未来的治疗策略可能会越来越依赖于这些生物标记的检测和分析，以实现对疾病的早期诊断、风险评估和个性化治疗。此外，随着全球人口老龄化的趋势，预防和治疗缺血性脑卒中的挑战也在不断增加。研究强调，改善全球卫生系统对脑卒中的响应能力，特别是在低收入国家，对于降低脑卒中的整体负担至关重要。因此，未来的研究和公共卫生策略需更多地关注遗传和免疫机制的作用，以提高治疗的及时性和有效性。本综述旨在提出基于最新研究成果的更新和更有效的诊疗策略，减少缺血性脑卒中的病死率和残疾率，改善患者的生活质量，并减轻其对家庭和社会经济的影响。同时，这些信息可为医学界和公共卫生政策制定者提供有价值的参考和指导，特别是在遗传和免疫方面的研究进展，预示着治疗缺血性脑卒中的未来方向。

Abstract: Ischemic stroke is the most common type of stroke worldwide and has a serious impact on the health and economy of the global population, especially in the elderly population. Currently, emergency treatment relies heavily on thrombolysis with specific drugs in the early stages of the disease, as well as the use of mechanical thrombolysis techniques to extend the treatment time window. Although these approaches have improved the timeliness and efficacy of treatment, there are still many challenges to overcome, particularly in the optimization of treatment strategies and personalization of therapy. Recent studies have shown that genetic factors and the immune microenvironment play key roles in the onset and progression of ischemic stroke. A deeper understanding of these factors will not only help the medical community to better understand the complex pathological mechanisms of stroke, but will also facilitate the development of more precise therapeutic approaches. Studies have pointed out that specific genetic backgrounds have a significant impact on the risk of stroke, while the immune status of the patient also plays a crucial role in the process of stroke injury and recovery. Therefore, future therapeutic strategies may increasingly rely on the detection and analysis of these biomarkers for early diagnosis, risk assessment and personalized treatment of the disease. In addition, the challenge of preventing and treating ischemic stroke is increasing with the global trend of an aging population. The study emphasizes that improving the responsiveness of global health systems to stroke, especially in low-income countries, is critical to reducing the overall burden of stroke. Therefore, future research and public health strategies need to focus more on the role of genetic and immune mechanisms to improve the timeliness and effectiveness of treatment. The aim of this review is to propose newer and more effective diagnostic and treatment strategies based on the latest research findings to reduce the morbidity, mortality, and disability of ischemic stroke, to improve the quality of life of the patients, and to mitigate its impact on the family and the socio-economy. At the same time, this information may provide valuable references and guidance to the medical community and public health policy makers, especially the research advances in genetics and immunity, which herald the future direction of treating ischemic stroke.