動脈瘤性蛛網(wǎng)膜下腔出血后的遲發(fā)性腦缺血是患者嚴(yán)重殘疾甚至死亡的主要原因，遲發(fā)性腦缺血形成的主要危險因素是腦血管痙攣。西洛他唑是磷酸二酯酶Ⅲ的選擇性抑制劑，可舒張血管、抗脂質(zhì)過氧化、抗血管炎癥因子、抑制基底動脈的表型轉(zhuǎn)化和內(nèi)皮損傷以及抑制腱糖蛋白-C。近年來一系列臨床試驗表明西洛他唑單用或者聯(lián)合使用可有效治療動脈瘤性蛛網(wǎng)膜下腔出血后的腦血管痙攣，進(jìn)而改善遲發(fā)性腦缺血。回顧了西洛他唑在動脈瘤性蛛網(wǎng)膜下腔出血中的作用機制和臨床研究，為進(jìn)一步研究西洛他唑在動脈瘤性蛛網(wǎng)膜下腔出血中的應(yīng)用提供參考。

Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage is the main cause of severe disability and even death in patients, and the main risk factor for the formation of delayed cerebral ischemia is cerebral vasospasm. Cilostazol is a selective inhibitor of phosphodiesterase III, which can dilate blood vessels, resist lipid peroxidation, inhibit vascular inflammatory factors, inhibit basal artery phenotype transformation and endothelial injury, and inhibit tenascin-C. In recent years, a series of clinical trials have shown that cilostazol alone or in combination can effectively treat cerebral vasospasm after aneurysmal subarachnoid hemorrhage, thereby improving delayed cerebral ischemia. This article reviews the mechanism of action and clinical research of cilostazol in treatment of aneurysmal subarachnoid hemorrhage, providing reference for further research on the application of cilostazol in treatment of aneurysmal subarachnoid hemorrhage.

R971

上海市臨床藥學(xué)重點?？平ㄔO(shè)項目（滬衛(wèi)計藥政[2018]5號）