缺血性中风是一种由大脑局部血流中断引起的脑血管疾病。缺血侧脑组织的快速有效再生是治疗缺血性中风的关键措施,但在再生和复流过程中存在再灌注损伤的风险。脑缺血再灌注损伤(cerebral ischemia-reperfusion injury,CIRI)作用机制复杂,其过程涉及多种病理环节及信号通路。铁死亡(ferroptosis)是近年来被广泛关注的新型非凋亡性细胞死亡形式,脂质过氧化与铁超载是铁死亡的重要环节,而线粒体铁蛋白可能在铁死亡过程中起到保护作用。中医药具有多靶点、多途径的优势,以中医药干预铁死亡可能是未来治疗CIRI的新方向。本文简要综述了铁死亡的特点及发生机制,探讨中医药干预细胞铁死亡的研究现状,为进一步提升缺血性脑卒中的中医疗效提供参考。

Ischemic stroke is a cerebrovascular disease caused by a regional disruption of cerebral blood flow to the brain. Although rapid and effective regeneration of the ischemic brain tissue is crucial to the treatment of ischemic stroke, there exists a risk of reperfusion injury during regeneration. The underlying mechanism of cerebral ischemia-reperfusion injury (CIRI) is complex, involving multiple pathological processes and signaling pathways. Ferroptosis is a new form of non-apoptotic cell death that has aroused extensive concern in recent years, during which process lipid peroxidation and iron overload play crucial roles while mitochondrial ferritin may be protective. Multi-target and multi-pathway as the advantages, traditional Chinese medicine (TCM) may be a new direction targeted at ferroptosis for future treatment of CIRI. This article reviews the characteristics and pathogenesis of ferroptosis and investigates the current status of TCM interventions in ferroptosis, providing a reference for further enhancing the efficacy of TCM in the treatment of ischemic stroke.