侧支代偿对脑梗死静脉溶栓治疗作用

Collateral status in intravenous thrombolysis for acute ischemic stroke

静脉溶栓应用于临床治疗急性脑梗死已经有20年,但其临床现状仍不容乐观,尤其是治疗时间窗的限制使绝大部分患者无法接受该治疗。侧支代偿对半暗带的维持起到关键作用,是再灌注治疗的前提。众多临床证据表明,良好的侧支代偿不仅可以延长静脉溶栓的治疗时间,使更多患者有机会接受该治疗,而且可以提高溶栓治疗的效果,减少并发症的出现。

Although the application of intravenous thrombolysis in clinical practice has been for 20 years, the clinical situation is still far from satisfying. The rigid window time has been limiting most patients from receiving this therapy. Collateral blood flow plays a pivotal role in the survival of penumbral tissue which is the precondition of reperfusion therapy. Many studies have shown that good collateral status can not only prolong the window time of intravenous thrombolysis, thus benefiting more patients, but also improves its efficacy and reduces the occurrence of complications.