Cerebral ischemia is a cerebrovascular disease with high morbidity and mortality that poses a significant burden on society and the economy. About 60% of cerebral ischemia is caused by thrombus, and the formation of thrombus proceeds from insoluble fibrin, following its transformation from liquid fibrinogen. In thrombus-induced ischemia, increased permeability of the blood–brain barrier (BBB), followed by the extravasation of blood components into the brain results in an altered brain microenvironment. Changes in the brain microenvironment affect brain function and the neurovascular unit (NVU), the working unit of the brain. Recent studies have reported that coagulation factors interact with the NVU and its components, but the specific function of this interaction is highly speculative and warrants further investigations. In this article, we reviewed the role of coagulation factors in cerebral ischemia and the role of coagulation factors in thrombosis. Additionally, the influence of thrombin on the NVU is introduced, as well as in the function of NVU, which may help to explore part of brain injury mechanism during ischemia. Lastly, we propose some novel therapeutic approaches on ischemic stroke by reducing the risk of coagulation.

脑缺血是一种高发病率和高死亡率的脑血管疾病，对社会和经济造成重大负担。大约 60% 的脑缺血是由血栓引起的，血栓的形成是由不溶性纤维蛋白经过液体纤维蛋白原转化而成的。在血栓引起的缺血中，血脑屏障 (BBB) 的通透性增加，随后血液成分外渗到大脑中，导致大脑微环境发生改变。大脑微环境的变化会影响大脑功能和神经血管单元 (NVU)，即大脑的工作单元。最近的研究报告说，凝血因子与 NVU 及其成分相互作用，但这种相互作用的具体功能是高度推测性的，值得进一步研究。在本文中，我们回顾了凝血因子在脑缺血中的作用以及凝血因子在血栓形成中的作用。此外，还介绍了凝血酶对 NVU 的影响，以及对 NVU 功能的影响，这可能有助于探索缺血过程中脑损伤的部分机制。最后，我们提出了一些通过降低凝血风险来治疗缺血性中风的新方法。