The ischemic penumbra: a new opportunity for neuroprotection.
The ischemic penumbra: a new opportunity for neuroprotection.
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DOI：
10.1159/000091705
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发表时间：
2006-01-01
期刊：
影响因子：
--
通讯作者：
Fisher, Marc
中科院分区：
文献类型：
--
作者：
Fisher, Marc
急性卒中治疗的发展在多项临床试验中仅取得了有限的成功和许多失败。急性卒中治疗的目标是缺血区域中仍有可能挽救的部分，即缺血半暗带。神经保护药物有可能防止部分缺血半暗带演变为梗死组织，设计针对持续性半暗带患者的神经保护药物试验应提高积极结局的可能性。目前，弥散和灌注MRI有可能近似缺血半暗带的位置和持续性，并可用于临床试验，以选择合适的患者入选并评价有意义的治疗效果。灌注CT也可以具有类似的能力。在临床试验中使用这些成像方式，并最终在临床实践中可能会有助于开发和利用新的神经保护药物。
The development of acute stroke therapies has yielded only limited success and many failures in multiple clinical trials. The target of acute stroke therapy is that portion of the ischemic region that is still potentially salvageable, i.e. the ischemic penumbra. Neuroprotective drugs have the potential to prevent a portion of the ischemic penumbra from evolving into infracted tissue and designing trials that target neuroprotective drugs at patients with persistent penumbra should enhance the likelihood of a positive outcome. Currently, diffusion and perfusion MRI has the potential to approximate the location and persistence of the ischemic penumbra and can be used in clinical trials to select appropriate patients for inclusion and to evaluate a meaningful treatment effect. Perfusion CT may also have similar capabilities. Use of these imaging modalities in clinical trials and ultimately in clinical practice will likely help in the development and utilization of novel neuroprotective drugs.