急性缺血性卒中静脉溶栓治疗进展

Updates on intravenous thrombolytic therapy of acute ischemic stroke

急性缺血性卒中(AIS)治疗的关键在于尽早开始再灌注治疗,挽救缺血半暗带。重组组织型纤溶酶原激活剂可溶解血液纤维凝块,使闭塞的血管再通,已在诸多国家获得AIS一线治疗药物的批准,并列入了治疗指南。近年来,随着多项相关临床研究成果发布,溶栓治疗应用要点也随着研究的深入而不断更新。本文对AIS的静脉溶栓治疗的卒中绿色通道、超时间窗溶栓、新型溶栓药物、影像学筛查、脑细胞保护等热点问题的研究进展进行综述,希望为临床决策提供参考。

The key to treating acute ischemic stroke (AIS) is to start reperfusion therapy as early as possible to rescue the ischemic penumbra. Recombinant tissue plasminogen activator (rt-PA), which dissolves blood fibrous clots and recanalizes occluded vessels, has been approved as a preferred treatment for AIS in many countries and is included in treatment guidelines. With the publication of several relevant clinical research results, the application of thrombolytic therapy has been updated. This article reviews the research progress of hot issues such as green channel for stroke, broadened therapeutic window, new thrombolytic drugs, imaging screening, and cytoprotection for intravenous thrombolytic therapy of AIS, and hope to provide references for clinical decision-making.