中国卒中杂志 ›› 2021, Vol. 16 ›› Issue (10): 1075-1081.DOI: 10.3969/j.issn.1673-5765.2021.10.017

• 综述 • 上一篇    下一篇

轻型卒中患者的溶栓治疗进展

闫然, 熊云云, 李子孝   

  1. 1北京 100070首都医科大学附属北京天坛医院神经病学中心
    2国家神经系统疾病临床医学研究中心
    3北京脑科学与类脑研究中心
    4国家神经系统疾病医疗质量控制中心
  • 收稿日期:2021-03-18 出版日期:2021-10-20 发布日期:2021-10-20
  • 通讯作者: 熊云云 xiongyunyun@bjtth.org 李子孝 lizixiao2008@hotmail.com
  • 基金资助:
    国家自然科学基金(81671172;92046016)
    北京市自然科学基金(Z20J00101;Z200016)
    国家重点研发计划(2017YFC1310900)

Advances in Intravenous Thrombolysis for Mild Stroke Patients

  • Received:2021-03-18 Online:2021-10-20 Published:2021-10-20

摘要: 轻型卒中的定义及标准目前尚未统一,其是否需要溶栓是卒中领域尚未解决的问题之一。 轻型卒中在卒中患者中的比例较大且有上升趋势,并且增加致残和复发的风险。轻型卒中患者即便在 4.5 h内到达医院也常因症状较轻而未能接受溶栓治疗,而这些未溶栓患者中有29%预后不良。轻型 卒中患者溶栓治疗的有效性及安全性均存在很大争议,而溶栓治疗的时间窗、卒中是否致残、NIHSS 评分、病因学分型等因素均可影响其预后,需要更多的研究来评估溶栓治疗对轻型卒中患者的意义。

文章导读: 轻型卒中患者比例很大且预后不佳,目前研究对轻型卒中患者溶栓治疗的有效性及安全性均存在很大争议,期待进一步高质量的研究为临床实践提供更多依据。

关键词: 轻型卒中; 溶栓治疗; 阿替普酶; 预后; 影响因素

Abstract: Whether mild stroke patients should receive thrombolytic therapy remains an unresolved problem. The definition and standard for mild stroke are not unified till now. Mild stroke accounts for a large proportion in stroke and has an increasing trend at home and abroad. It increased the risk of disability and stroke recurrence. Patients with mild stroke often fail to receive intravenous thrombolysis even if they arrive at the hospital within the 4.5-hour time window, and 29% of these patients without thrombolysis have a poor outcome. The safety and efficacy of thrombolytic therapy in patients with mild stroke are controversial. The time window, disability or not, NIHSS score, etiological type and other factors all can affect the prognosis. More studies are needed to evaluate the significance of thrombolytic therapy in patients with mild stroke.

Key words: Mild stroke; Thrombolytic therapy; Alteplase; Prognosis; Predictor