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  • 邓本强*,沈红健.急性缺血性脑卒中静脉溶栓治疗:新证据、新热点[J].第二军医大学学报,2018,39(9):959-964    [点击复制]
  • DENG Ben-qiang*,SHEN Hong-jian.Intravenous thrombolysis for acute ischemic stroke: new evidence and focus[J].Acad J Sec Mil Med Univ,2018,39(9):959-964   [点击复制]
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急性缺血性脑卒中静脉溶栓治疗:新证据、新热点
邓本强*,沈红健
0
(海军军医大学(第二军医大学)长海医院脑血管病中心, 上海 200433
*通信作者)
摘要:
急性缺血性脑卒中(AIS)具有高患病率、高致残率、高病死率等特点。时间窗内重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓是目前国内外指南一致推荐的治疗AIS的有效方法,但此方法存在治疗时间窗窄、大血管闭塞再通率低、出血风险高等缺点。为此,近年来在AIS的治疗上,借助影像学方法延长溶栓时间窗、采用低剂量rt-PA或新一代溶栓药物、溶栓联合抗栓治疗等方面的研究在世界范围内相继开展。本文结合近年来静脉溶栓相关研究提供的证据,探讨扩大治疗时间窗、低剂量rt-PA溶栓、新一代溶栓药物等几个热点话题的最新进展。
关键词:  急性缺血性脑卒中  静脉溶栓疗法  重组组织型纤溶酶原激活剂  低剂量  替奈普酶
DOI:10.16781/j.0258-879x.2018.09.0959
投稿时间:2018-09-05修订日期:2018-09-10
基金项目:上海市科技创新行动计划重点项目(14401970304),上海市自然科学基金(18ZR143850).
Intravenous thrombolysis for acute ischemic stroke: new evidence and focus
DENG Ben-qiang*,SHEN Hong-jian
(Stroke Center, Changhai Hospital, Navy Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Acute ischemic stroke (AIS) has the characteristics of high morbidity, disability and mortality. Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) for AIS in time window is an effective treatment recommended by domestic and overseas guidelines. However, intravenous thrombolysis has shortcomings, such as short time window, low recanalization rate and high risk of bleeding. Therefore, in recent years, studies on prolonging the time window, using low-dose rt-PA or a new generation of thrombolytic agent, and thrombolysis combined with anti-thrombotic therapy have been carried out worldwide. Based on the studies on intravenous thrombolysis, this paper discusses several issues, including extending time window, low-dose rt-PA thrombolysis, and new generation of thrombolytic agent.
Key words:  acute ischemic stroke  intravenous thrombolytic therapy  recombinant tissue plasminogen activator  low-dose  tenecteplase