缺血性脑卒中神经保护剂临床转化研究进展

Progress in the clinical transformation study of neuroprotectants in ischemic stroke

脑卒中是中老年常见的急性脑血管病,是当今世界最主要的致死性疾病之一,其中缺血性脑卒中约占患者总数80%。我国脑卒中具有"高发病率、高死亡率、高致残率、高复发率、高经济负担"5大特点,是第一位死亡原因。除血管再通外,神经保护剂是目前最具潜力的一种脑卒中治疗策略。神经保护剂的研究已开展很长时间,目前已涉及49个种类,上百项临床试验,但多数药物在动物实验中证实有效,而在临床试验中无效或存在严重不良反应,其可能原因包括药物临床前实验及临床试验相关的多种复杂因素。本文重点阐述缺血性脑卒中神经保护剂临床转化过程中存在的问题及应对策略的相关研究进展。

Stroke is a common acute cerebrovascular disease in middle-aged and old people. It is the most dangerous diseases in the world today. Ischemic stroke accounts for about 80% of stroke patients. In our country , the stroke presents characteristics of “high morbidity, high mortality, high recurrence rate and high economic burden” and it is also the first cause of death. Besides vascular revascularization, neuroprotectant is the most promising strategy for treatment of ischemic stroke. The studies on neuroprotectants have been carried out for a long time. Currently, there are about 49 species of neuroprotectants involved in nearly hundreds of clinical trials. However, most of that proved effective in animal experiments failed clinical trials for poor efficacy or severe adverse events. The causes of the failure include a variety of complex factors related with the preclinical experiments and clinical trials. This paper reviews the existing problems in the clinical transformation of neuronprotectants for ischemic stroke and the research progress of the solutions.