急性缺血性脑卒中伴高血糖溶栓治疗的研究进展

Research progress of thrombolytic therapy in acute ischemic stroke with hyperglycemia

缺血性脑卒中是目前导致死亡的第四大病因。静脉注射组织型纤溶酶原激活剂（tPA）可快速恢复缺血组织的血流,是目前治疗急性缺血性脑卒中的有效方案。但30%~40%的脑卒中患者伴高血糖,而急性脑卒中时血糖升高会增加tPA治疗的出血风险,导致临床预后差、死亡率高。目前,高血糖和tPA加重脑卒中后神经血管损伤的机制并不完全清楚,对血糖的控制及tPA的用法仍存在争议。

Ischemic stroke is considered the fourth leading cause of death. Tissue plasminogen activator（t PA）, which can be used to restore blood flow to the ischemic tissue through intravenous injection, has proven to be effective therapy for treating acute ischemic stroke. But 30%-40% of stroke patients present with hyperglycemia, elevated blood glucose in acute stroke can increase the risk of bleeding with t PA treatment and it is associated with poor prognosis and high mortality rates. Currently, the mechanism through which hyperglycaemia and t PA worsen the neurovascular injury after stroke are far from clear, and the control of blood glucose and t PA treatment are still controversial.