Caplan Louis R
Department of Neurology, Harvard Medical School, Cambridge, MA, USA.
Rev Neurol Dis. 2004 Winter;1(1):16-26.
Nearly 8 years have passed since the U.S. Food and Drug Administration (FDA) released recombinant tissue plasminogen activator (rt-PA) for treatment of patients with acute ischemic stroke. Yet thrombolysis remains an intensely controversial treatment strategy. Clearly thrombolysis is a step forward but there remain problems with its application. The author reviews early investigations that preceded the National Institute of Neurological Disorders and Stroke (NINDS) trial report, discusses NINDS and other randomized trials, and comments on results since the approval and release of tissue type plasminogen activator (tPA). Technology development and use have improved since the release of tPA, and the impact of this development is discussed. Finally, the author shares his advice to doctors about present thrombolytic management of patients with acute ischemic stroke.
自美国食品药品监督管理局（FDA）批准使用重组组织型纤溶酶原激活剂（rt-PA）治疗急性缺血性中风患者以来，已经过去了近8年。然而，溶栓治疗仍然是一个极具争议的治疗策略。显然，溶栓治疗是向前迈出的一步，但在应用方面仍存在问题。作者回顾了在国立神经疾病与中风研究所（NINDS）试验报告之前的早期研究，讨论了NINDS试验和其他随机试验，并对组织型纤溶酶原激活剂（tPA）获批和上市后的结果发表了评论。自tPA上市以来，技术的发展和应用已经有所改善，本文将讨论这一发展的影响。最后，作者就目前急性缺血性中风患者的溶栓治疗管理向医生提供了建议。
