Weinberger Jesse M
Mt. Sinai School of Medicine, One Gustave L. Levy Place, Box 1139, New York, NY 10029, United States.
J Neurol Sci. 2006 Nov 15;249(2):101-9. doi: 10.1016/j.jns.2006.06.010. Epub 2006 Sep 26.
Stroke contributes significantly to death, disability, and healthcare costs; however, recombinant tissue plasminogen activator (rt-PA) is the only approved thrombolytic therapy for acute ischemic stroke. One area of development for new ischemic stroke treatment options is focused on neuroprotection of viable tissue in the ischemic vascular bed. The ischemic penumbra is recognizable on MRI by decreased perfusion, in contrast to the core area of ischemia, which includes diffusion and perfusion abnormalities. Understanding the mechanisms of neuronal death, including the role of excitotoxic neurotransmitters, free radical production, and apoptotic pathways, is important in developing new therapies for stroke. This article reviews these causes and results of stroke, as well as current and future neuroprotective treatment options. Several compounds have shown neuroprotective effects in animal studies, but have failed to be effective in human clinical trials. Several promising therapeutic areas include targeting of free radicals, modulation of glutamatergic transmission, and membrane stabilization via ion channels.
中风对死亡、残疾和医疗成本有重大影响；然而，重组组织型纤溶酶原激活剂（rt-PA）是唯一被批准用于急性缺血性中风的溶栓治疗方法。新的缺血性中风治疗方案的一个发展领域集中在对缺血血管床中存活组织的神经保护上。与包括扩散和灌注异常的缺血核心区域相比，缺血半暗带在MRI上可通过灌注减少来识别。了解神经元死亡的机制，包括兴奋性毒性神经递质的作用、自由基产生和凋亡途径，对于开发中风新疗法很重要。本文综述了中风的这些病因和后果，以及当前和未来的神经保护治疗方案。几种化合物在动物研究中显示出神经保护作用，但在人体临床试验中未能取得成效。几个有前景的治疗领域包括针对自由基、调节谷氨酸能传递以及通过离子通道实现膜稳定。
