Nyquist Paul, LeDroux Shannon, Geocadin Romergryko
Division of Neurosciences Critical Care, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 8-138, Baltimore, MD 21287-7840, USA.
Curr Neurol Neurosci Rep. 2007 Nov;7(6):522-8. doi: 10.1007/s11910-007-0080-9.
Intraventricular hemorrhage (IVH) may occur as an isolated event from primary ventricular bleeding or as a complication of brain hemorrhage from another etiology. It is associated with high mortality and morbidity. Recent translational and clinical studies demonstrate that thrombolytic drugs administered intraventricularly through an external ventricular drain to lyse an IVH clot are safe and may reduce morbidity and mortality. The ongoing, prospective, randomized clinical trial known as Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage (CLEAR IVH) offers new hope for patients with this devastating disease. Preliminary data show marked reduction in time to clot lysis as well as a potential reduction in mortality associated with IVH lysis. A large, phase III, randomized prospective trial to ascertain the true clinical efficacy of this treatment is currently in the planning stages. A review of the use of thrombolytics for treatment of IVH related to other secondary causes is also provided.
脑室内出血（IVH）可能是原发性脑室出血的孤立事件，也可能是其他病因导致脑出血的并发症。它与高死亡率和高发病率相关。最近的转化研究和临床研究表明，通过外部脑室引流管向脑室内注射溶栓药物以溶解IVH血凝块是安全的，并且可能降低发病率和死亡率。正在进行的名为“血凝块溶解：评估脑室内出血加速溶解”（CLEAR IVH）的前瞻性随机临床试验为患有这种毁灭性疾病的患者带来了新希望。初步数据显示，血凝块溶解时间显著缩短，并且与IVH溶解相关的死亡率可能降低。一项旨在确定这种治疗方法真正临床疗效的大型III期随机前瞻性试验目前正处于规划阶段。本文还综述了溶栓药物用于治疗与其他继发原因相关的IVH的情况。
