急性缺血性卒中治疗时间窗的研究进展

Progress of Therapeutic Time Window for Acute Ischemic Stroke

急性缺血性卒中再通治疗是一个多因素、多环节作用的复杂临床干预过程。在长期的临床实践过程中,"时间窗"是一个普遍沿用的概念。早在1996年,3 h内溶栓治疗就已经被证明是急性缺血性卒中的有效治疗手段,然而获得治疗的患者很少,除了治疗时间窗的限制、未能及时就诊等原因,单纯的"时间窗"往往提供不了足够的信息以保证溶栓治疗的安全性和有效性。基础血管病变、侧支循环和缺血耐受的不同,时间窗是否也存在个体差异呢?随着神经影像技术的发展与进步,20多年来国内外学者一直致力于延长卒中治疗时间窗等方面的研究。

Recanalization treatment for acute ischemic stroke is a complicated clinical intervention process, which involves multiple factors and points. Over a long period of time, the concept of ＂Time Window＂ is widely used in clinical practice. The efficacy and safety of thrombolytie therapy administered within 3 hours of symptom onset in the treatment of acute ischemic stroke had been proved in 1996. However, beyond the limit of the therapeutic time window and late to medical attention, the safety and validity of recanalization treatment for acute ischemic stroke cam^ot be ensured by the only ＂Time Window＂. Is there any individual difference in ＂Time window＂ based on the different baseline cerebral arterial lesion, collateral circulation and ability of ischemic stroke？ With the development and progress of neuroimaging technology, scholars home and abroad have been working on how to extend the therapeutic time window over the past 20 years.