阿加曲班联合阿替普酶治疗缺血性脑卒中的研究进展

Advances in research of Argatroban combined with Alteplase in the treatment of ischemic stroke

脑卒中是神经科的主要疾病,在我国疾病死亡原因中占首位。该病起病急骤,可致患者躯体功能障碍、降低生活质量,给个人、家庭和社会带来沉重的负担。其中,缺血性脑卒中有效的治疗方法为时间窗内静脉溶栓,快速恢复血流以抢救缺血半暗带,但有效性欠佳,且个体差异较大。阿加曲班为直接凝血酶抑制剂,高选择性地与凝血酶催化位点结合,发挥抑制效应;而阿替普酶能够显著上调纤溶系统活性,快速有效消除栓子及促进梗死血管再通。通过查阅国内外相关文献,发现阿加曲班联合联合阿替普酶可提高缺血性脑卒中的治疗效果,且不增加死亡率及症状性颅内出血的风险。本文以阿加曲班联合阿替普酶治疗缺血性脑卒中的效果作一综述。

Stroke is the main disease in neurology,and it is the first cause of death in our country,which starts quickly,and can cause physical dysfunction,reduce quality of life,and put a heavy burden on individuals,families and society.Among them,the effective treatment of ischemic stroke is intravenous thrombolysis in the time window,rapid recovery of blood flow to rescue the ischemic penumbra,but the effectiveness is not good,and the individual differences are large.Argatroban is a direct thrombin inhibitor that binds to the catalytic site of thrombin with high selectivity and exerts an inhibitory effect.Alteplase can significantly up-regulate the activity of fibrinolytic system,quickly and effectively eliminate emboli and promote infarcted blood vessels recanalization.By researching relevant literatures at home and abroad,it is found that Argatroban combined with Alteplase can improve the therapeutic effect of ischemic stroke without increasing the risk of mortality and symptomatic intracranial hemorrhage.This article reviews the effect of Argatroban combined with Alteplase in the treatment of ischemic stroke.