急性缺血性卒中急性期药物治疗进展

Advances in pharmacotherapy for the acute stage of acute ischemic stroke

摘要

卒中是我国成人致死、致残的第一位病因。急性缺血性卒中（acute ischemic stroke，AIS）是卒中最常见的类型，严重影响患者生活质量，造成沉重的疾病负担，其防治是医学领域亟待解决的重大问题。AIS的发病机制复杂，治疗上应基于对患者的整体评估进行综合决策，并遵循规范的诊治流程。目前针对AIS急性期的治疗策略主要有两方面，一是尽早开通阻塞血管恢复脑组织灌注，挽救缺血半暗带；二是多靶点抑制缺血性病理生理级联反应，保护脑细胞。近年来，AIS在溶栓、抗血小板以及细胞保护各领域的药物治疗发展迅速，本文结合目前国内外的相关研究成果，对AIS急性期药物治疗进展做一综述，为更多有效治疗药物的研发提供科学依据和思路。

Abstract

Stroke ranks first among the causes of death and disability in Chinese adults. Acute ischemic stroke（AIS） is the most common type of stroke that seriously affects the quality of life of patients and imposes a heavy disease burden，and therefore，the prevention and treatment of AIS is a major problem that needs to be addressed urgently. AIS has a complex pathogenesis，and overall assessment of patients should be performed to make a comprehensive decision，while following the standardized diagnosis and treatment process. There are currently two main therapeutic strategies for the acute stage of AIS，i.e.，timely recanalization of the obstructed vessels to restore the perfusion of brain tissue and rescue the ischemic penumbra and inhibition of the ischemic cascades through multiple targets to protect brain cells. In recent years，rapid progress has been made in pharmacotherapy for AIS in the fields of thrombolysis，antiplatelet therapy，and cytoprotection. With reference to related research findings in China and globally，this article reviews the advances in pharmacotherapy for the acute stage of AIS，in order to provide a scientific basis and ideas for the research and development of other effective therapeutic drugs.

关键词

急性缺血性卒中 / 药物治疗 / 溶栓 / 抗血小板 / 脑保护剂

Key words

acute ischemic stroke / pharmacotherapy / thrombolysis / antiplatelet therapy / cerebral protective agent

基金资助

国家自然科学基金面上资助项目(81771287)

重庆市技术创新与应用发展专项面上资助项目(cstc2019jscx-msxmX0285)

重庆市自然科学基金面上资助项目(CSTB2022NSCQ-MSX1585)