Ducruet Andrew F, Grobelny Bartosz T, Zacharia Brad E, Hickman Zachary L, Yeh Mason L, Connolly E Sander
Columbia University, Department of Neurological Surgery, 710 West 168th Street, New York, NY 10032, USA.
Expert Opin Pharmacother. 2009 Aug;10(12):1895-906. doi: 10.1517/14656560903055095.
Ischemic stroke remains one of the leading causes of death and disability in the developed world. Despite many promising preclinical results, the only pharmacologic treatments proven effective in improving clinical outcome following ischemic stroke until now are administration of aspirin and acute thrombolysis using tissue-plasminogen activator.
To review currently approved pharmacologic therapies as well as promising future treatment strategies for acute ischemic stroke.
We performed an exhaustive PubMed search for articles published from 1950 through 2009 describing pharmacotherapy of acute ischemic stroke, focusing on agents that are currently in Phase III trials or approved for clinical use. Following this review, we present our interpretation of the existing literature and our vision of the future of pharmacotherapy for ischemic stroke.
RESULTS/CONCLUSIONS: Since the clinical success of the first intravenous thrombolytic, many studies have sought to further characterize the ideal patient population and to extend the therapeutic time window for pharmacologic thrombolysis. Additionally, despite the many failures of neuroprotective trials, several promising agents are currently undergoing Phase III investigation. With the advent of interventional techniques enabling local delivery of therapeutics into the region of the thrombus, the future of pharmacotherapy for ischemic stroke will probably include a combination of interventional techniques and pharmacotherapy.
在发达国家，缺血性中风仍然是导致死亡和残疾的主要原因之一。尽管临床前研究取得了许多有前景的结果，但迄今为止，在改善缺血性中风临床结局方面被证明有效的唯一药物治疗方法是服用阿司匹林和使用组织纤溶酶原激活剂进行急性溶栓治疗。
综述目前已获批准的急性缺血性中风药物治疗方法以及未来有前景的治疗策略。
我们对1950年至2009年期间发表的描述急性缺血性中风药物治疗的文章进行了全面的PubMed检索，重点关注目前处于III期试验或已获批准用于临床的药物。在本次综述之后，我们阐述了对现有文献的解读以及对缺血性中风药物治疗未来的展望。
结果/结论：自首次静脉溶栓治疗取得临床成功以来，许多研究致力于进一步明确理想的患者群体，并延长药物溶栓的治疗时间窗。此外，尽管神经保护试验多次失败，但目前有几种有前景的药物正在进行III期研究。随着能够将治疗药物局部递送至血栓部位的介入技术的出现，缺血性中风药物治疗的未来可能会包括介入技术与药物治疗的联合应用。
