脑组织对缺血高度敏感,即使是短暂的缺血也会诱发一系列复杂事件,最终导致脑细胞死亡.心搏骤停为全脑缺血状态,所以首要处理是恢复脑血流.然而,脑血流恢复会对心搏骤停患者造成额外的损害,并加重其神经认知功能障碍.因此,心搏骤停后脑损伤的病理生理过程是一个复杂的级联反应,涉及多个环节,如能量代谢障碍、兴奋性氨基酸毒性作用、钙超载、氧自由基损伤、炎症反应、线粒体损伤、内质网应激、细胞凋亡等,其中仍有很多不甚清楚.%Brain tissue is highly sensitive to ischemia ,such that even brief ischemic periods in neurons can initiate a complex sequence of events that may ultimately result in cell death .After cardiac arrest the whole brain ischemia occurs ,so the primary intervention is to restore the cerebral blood flow .However ,restoration of blood flow can cause additional damage and exacerbate the neurocognitive deficits in patients suffering cardiac arrest .So the pathophysiology of post-cardiac arrest brain injury is a complicated process with a series of cascade reactions ,including many factors such as energy metabolism disturbance ,excitatory amino acids toxicity , calcium overloading , oxygen free radicals injury , inflammatory reactions , mito-chondrial injury ,endoplasmic reticulum stress ,apoptosis etc ,most of which remain unclear .
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