Gonzales Nicole R, Grotta James C
University of Texas, Houston Medical School, 6431 Fannin, MSB 7.118, Houston TX 7703, USA.
Expert Rev Cardiovasc Ther. 2006 May;4(3):301-18. doi: 10.1586/14779072.4.3.301.
Alteplase, an intravenously administered form of recombinant tissue plasminogen activator (rt-PA), remains the only US FDA-approved thrombolytic treatment for acute ischemic stroke within 3 h of symptom onset. Patients treated with intravenous rt-PA are at least 30% more likely to have minimal or no disability at 3 months compared with placebo. Despite an increased risk of symptomatic intracranial hemorrhage, rt-PA does not increase mortality. The benefit achieved with rt-PA is cost effective and sustained 1 year after treatment. Despite its clear benefit, rt-PA remains underutilized. Although the future of acute ischemic stroke treatment will most likely involve a multi-faceted treatment approach, the primary objective remains to establish recanalization of the involved vessel. For patients with acute ischemic stroke within the first 3 h of symptom onset, rt-PA remains the first step in accomplishing this goal.
阿替普酶是重组组织型纤溶酶原激活剂（rt-PA）的静脉给药形式，仍然是美国食品药品监督管理局（FDA）批准的唯一用于症状发作后3小时内急性缺血性卒中的溶栓治疗药物。与安慰剂相比，接受静脉rt-PA治疗的患者在3个月时至少有30%的可能性仅有轻微残疾或无残疾。尽管有症状性颅内出血的风险增加，但rt-PA不会增加死亡率。rt-PA所带来的益处具有成本效益且在治疗后1年内持续存在。尽管其益处明显，但rt-PA的使用仍未得到充分利用。虽然急性缺血性卒中治疗的未来很可能涉及多方面的治疗方法，但其主要目标仍然是实现受累血管的再通。对于症状发作后3小时内的急性缺血性卒中患者，rt-PA仍然是实现这一目标的第一步。
