New perspectives on developing acute stroke therapy
New perspectives on developing acute stroke therapy
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DOI：
10.1002/ana.10407
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发表时间：
2003-01-01
影响因子：
11.2
通讯作者：
Ratan, R
中科院分区：
文献类型：
--
作者：
Fisher, M;Ratan, R
开发额外的急性卒中治疗以补充和补充卒中发作后前3小时内静脉注射重组组织型纤溶酶原激活剂仍然是重要且迫切的需求。关于急性卒中治疗的假定目标，缺血半暗带，以及临床可用的成像方式，如磁共振成像和计算机断层扫描，至少部分地识别潜在可挽救的缺血组织区域，已经有很多研究。了解缺血相关细胞损伤的生物学也迅速发展。新的治疗方法，以改善局灶性脑缺血后的结果可能会通过观察自然发生的适应性机制，如缺血预处理和冬眠。许多以前使用各种神经保护和溶栓药物进行的临床试验提供了许多经验教训，有助于指导未来的急性卒中治疗试验，并提高未来试验成功的可能性。结合这三个领域的知识提供了乐观的看法，即可以开发额外的急性卒中治疗，以最大限度地提高最大比例的急性卒中患者的有益功能结局。
The development of additional acute stroke therapies to complement and supplement intravenous recombinant tissue-type plasminogen activator within the first 3 hours after stroke onset remains an important and pressing need. Much has been teamed about the presumed target of acute stroke therapy, the ischemic penumbra, and clinically available imaging modalities such as magnetic resonance imaging and computed tomography hold great promise for at least partially identifying this region of potentially salvageable ischemic tissue. Understanding the biology of ischemia-related cell injury has also evolved rapidly. New treatment approaches to improve outcome after focal brain ischemia will likely be derived by looking at naturally occurring adaptive mechanisms such as those related to ischemic preconditioning and hibernation. Many clinical trials previously performed with a variety of neuroprotective and thrombolytic drugs provide many lessons that will help to guide future acute stroke therapy trials and enhance the likelihood of success in future trials. Combining knowledge from these three areas provides optimism that additional acute stroke therapies can be developed to maximize beneficial functional outcome in the greatest proportion of acute stroke patients possible.