急性缺血性脑卒中超时间窗静脉溶栓研究进展  

Research progress of intravenous thrombolysis beyond time window for acute ischemic cerebral infarction

作　　者：马丹 韩剑虹[1] MA Dan;HAN Jianhong(Department of Neurology,the Second Affiliated Hospital of Kunming Medical University,Yunnan,Kunming 650106,China)

机构地区：[1]昆明医科大学第二附属医院神经内科,云南昆明650106

出　　处：《中国医药科学》2022年第21期72-75,102,共5页China Medicine And Pharmacy

摘　　要：静脉溶栓是治疗急性缺血性脑卒中的有效方法,目前指南推荐对于符合条件的患者在发病4.5 h内给予静脉溶栓治疗。然而,静脉溶栓的治疗效果与发病时长相关,对于卒中发作时间超过4.5 h的急性缺血性脑卒中患者,静脉溶栓的疗效尚未确定。随着影像学检查技术的进步,一些研究提出了急性缺血性脑卒中超时间窗溶栓的概念,即根据神经影像检查错配结果可将溶栓时间窗推至9 h。本文对超时间窗静脉溶栓这一治疗方案特点进行综述,将从超时间窗溶栓的重要研究、神经科影像学工具、超时间窗溶栓的并发症治疗研究三方面进行阐述。为急性缺血性脑卒中超时间窗提供临床诊疗建议,为临床医师决策提供参考。Intravenous thrombolysis is an effective method for the treatment of acute ischemic cerebral infarction.At present,the guideline recommends that qualified patients be given intravenous thrombolysis within 4.5 hours of onset.However,the therapeutic effect of intravenous thrombolysis is related to the onset time.For patients with acute ischemic cerebral infarction whose stroke onset time exceeds 4.5 h,the therapeutic effect of intravenous thrombolysis has not been determined.With the progress of imaging examination technology,some studies put forward the concept of thrombolysis beyond time window for acute ischemic cerebral infarction,i.e.,the thrombolysis time window can be pushed to 9 h according to the mismatch results of neuroimaging examination.In this paper,the characteristics of intravenous thrombolysis beyond time window are reviewed,and it will be expounded from three aspects:important research on thrombolysis beyond time window,neurological imaging tools and research on complications of thrombolysis beyond time window,so as to provide clinical diagnosis and treatment suggestions for acute ischemic cerebral infarction beyond time window,and provide reference for clinicians to make decisions.

关 键 词：急性缺血性脑卒中 超时间窗 静脉溶栓 脑梗死出血性转化 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R-1[医药卫生—临床医学]