急性穿支动脉梗死的静脉溶栓治疗现状

doi:10.3969/j.issn.1673-5765.2020.09.004

摘要/Abstract

摘要：

穿支动脉梗死是脑梗死的特殊类型，其临床表现因受累血管部位及病理机制不同而多样化。部分患者症状轻微，可不进行溶栓治疗，而有相当一部分患者具有症状易反复和波动的临床特点，对单纯溶栓治疗反应不佳，但溶栓后出血转化风险也相对较低。本文对穿支动脉梗死溶栓的相关研究结果进行综述，评价穿支动脉梗死静脉溶栓的有效性与安全性，探索优化急性穿支动脉梗死溶栓治疗方案的必要性及可行性。

文章导读： 轻型非致残的穿支动脉梗死不推荐rt-PA静脉溶栓，可仅给予抗血小板药物治疗。对于有溶栓适应证者在积极进行溶栓的同时早期联合使用抗血小板、抗凝药物等有可能相对安全地提高患者溶栓获益程度。

关键词: 穿支动脉梗死; 静脉溶栓; 疗效

Abstract:

Perforating artery infarct is a particular type of ischemic stroke. Due to the different involved vessels and different pathological mechanisms, the clinical manifestations are various. Thrombolysis is not recommended in patients with mild nondisabling symptoms. However, thrombolysis is not effective enough in quite a few patients with acute perforating artery infarct characterized by recurrent and fluctuating symptoms, while the risk of hemorrhagic transformation after thrombolysis is relatively low. This article aims to review the development of intravenous thrombolysis for perforating artery infarcts, evaluate its efficacy and safety, and explore the necessity and feasibility of optimizing intravenous thrombolysis in acute perforating artery infarcts.

Key words: Perforating Artery infarct; Intravenous thrombolysis; Efficacy

吴娅，李玮. 急性穿支动脉梗死的静脉溶栓治疗现状[J]. 中国卒中杂志, 2020, 15(09): 942-946.

WU Ya, LI Wei. Status of Intravenous Thrombolysis for Acute Perforating Artery Infarcts[J]. Chinese Journal of Stroke, 2020, 15(09): 942-946.

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