The social and public health burdens of ischemic stroke have been increasing worldwide. In addition to focal brain damage, acute ischemic stroke (AIS) provokes systemic abnormalities across peripheral organs. AIS profoundly alters the autonomic nervous system, hypothalamic-pituitary-adrenal axis, and immune system, which further yield deleterious organ-specific consequences. Poststroke systemic pathological alterations in turn considerably contribute to the progression of ischemic brain injury, which accounts for the substantial impact of systemic complications on stroke outcomes. This review provides a comprehensive and updated pathophysiological model elucidating the systemic effects of AIS. To address their clinical significance and inform stroke management, we also outline the resulting systemic complications at particular stages of AIS and highlight the mechanisms. Future therapeutic strategies should attempt to integrate the treatment of primary brain lesions with interventions for secondary systemic complications, and should be tailored to patient individualized characteristics to optimize stroke outcomes.

缺血性中风的社会和公共卫生负担在世界范围内一直在增加。除了局灶性脑损伤外，急性缺血性中风 (AIS) 还会引起周围器官的系统异常。AIS 深刻地改变自主神经系统、下丘脑-垂体-肾上腺轴和免疫系统，进一步产生有害的器官特异性后果。中风后全身病理改变反过来大大促进了缺血性脑损伤的进展，这解释了全身并发症对中风结果的重大影响。本综述提供了一个全面和更新的病理生理学模型，阐明了 AIS 的全身效应。为了解决它们的临床意义并为中风管理提供信息，我们还概述了 AIS 特定阶段所导致的全身并发症，并强调了这些机制。未来的治疗策略应尝试整合原发性脑损伤与继发性全身并发症的干预措施，应根据患者的个体特征进行调整，以优化卒中结果。