急性脑梗死动脉溶栓治疗的进展与展望

Progress and prospect of intra-arterial thrombolytic therapy for acute cerebral infarction

急性脑梗死(ACI)是目前全球人口致残的首要原因,也是我国居民致死、致残的主要病因,脑血管的成功再通是获得良好预后的关键。目前,溶栓治疗是挽救缺血半暗带,治疗ACI的主要措施;尽管目前静脉溶栓(IAT)仍是临床医师的首选治疗方案,然而经过长期的研究与临床实践,人们已经广泛认识到,动脉溶栓(IVT)相比静脉溶栓能明显提高血管内药物浓度,提高血管再通率,扩大溶栓时间窗,且安全可靠;随着医疗设备及溶栓药物的发展进步,动脉溶栓仍有较大的发展空间。该文就动脉溶栓的操作方式、溶栓治疗进展和对前景的展望进行综述。

Acute cerebral infarction(ACI)is now a major cause of disability worldwide,and also the leading pathogenesis of causing death and causing disability among the residents in our country.Successful recanalization of cerebral vessels is the key to achieve good prognosis.At present,the thrombolytic treatment is the main measure for rescuing the ischemic penumbra and treating the patients with ACI.Although intravenous thrombolysis(IAT)is still the preferred treatment for clinicians.However after long-term research and clinical practice,it has been widely recognized that compared with intravenous thrombolysis(IVT),IAT can significantly increase the concentration of intravascular drugs,increase the vascular revascularization rate,expand the thrombolytic time window,morevover which is safe and reliable.With the development and progress of medical equipment and thrombolytic drugs,IAT still has great space for development.This paper reviews the operation mode of IAT,thrombolytic treatment progress and its future prospects.