Fisher Marc, Bastan Birgul
UMASS/Memorial Healthcare, 119 Belmont Street, Worcester, MA 01605, USA.
Curr Opin Drug Discov Devel. 2008 Sep;11(5):626-32.
Acute ischemic stroke (AIS) is a common disorder that has only one associated approved therapy: intravenous tissue plasminogen activator (iv t-PA). A limiting factor to the use of iv t-PA is that it must be initiated within 3 h of stroke onset. Efforts to expand the therapeutic time window are underway and include image evaluation of the ischemic penumbra to target those patients who are most appropriate for treatment. Intra-arterial t-PA is also used only in some treatment centers despite convincing proof of efficacy of this therapy. Devices to restore perfusion that have been approved in the US for recanalization exist, but these are not approved for use in stroke therapy. Many neuroprotective drugs have been evaluated as potential acute stroke therapies, but none have shown efficacy, hence the future of neuroprotection as a strategy for acute ischemic stroke therapy remains uncertain.
急性缺血性卒中（AIS）是一种常见疾病，目前仅有一种相关的获批疗法：静脉注射组织纤溶酶原激活剂（iv t-PA）。使用iv t-PA的一个限制因素是必须在卒中发作后3小时内开始使用。目前正在努力扩大治疗时间窗，包括对缺血半暗带进行影像评估，以确定最适合治疗的患者。尽管有令人信服的疗效证据，但动脉内注射t-PA也仅在一些治疗中心使用。在美国已获批用于再通的恢复灌注装置确实存在，但这些装置未获批用于卒中治疗。许多神经保护药物已被评估为潜在的急性卒中疗法，但均未显示出疗效，因此神经保护作为急性缺血性卒中治疗策略的未来仍不确定。
