Abe Koji
Department of Neurology, Graduate School of Medicine and Dentistry, Okayama University.
Rinsho Shinkeigaku. 2011 Nov;51(11):1182-4. doi: 10.5692/clinicalneurol.51.1182.
Neuroprotection is essential for therapy in acute stage of stroke. Both neurotrophic factors (NTFs) and free radical scavenger can be such neuroprotective reagents with inhibiting death signals and potentiating survival signals under cerebral ischemia. Edaravone, a free radical scavenger, is the first clinical drug for neuroprotection in the world which has been used from 2001 in most ischemic stroke patients in Japan. Edaravone scavenges hydroxyl radicals both in hydrophilic and hydrophobic conditions, and is especially useful in thrombolytic therapy with tissue plasminogen activator (tPA). Combination therapy of Edaravone with tPA greatly increased survival of stroke animals, reduced infarct size, and inhibited molecular markers of oxidative damage in lipid, protein and DNA. Use of Edaravone greatly reduced hemorrhagic transformation accompanied by tPA treatment, and may also extend therapeutic time window with tPA therapy for more than 3 hr in human stroke patients.
神经保护对于中风急性期的治疗至关重要。神经营养因子（NTFs）和自由基清除剂都可以是这样的神经保护试剂，在脑缺血时抑制死亡信号并增强生存信号。依达拉奉是一种自由基清除剂，是世界上第一种用于神经保护的临床药物，自2001年以来已在日本的大多数缺血性中风患者中使用。依达拉奉在亲水和疏水条件下均能清除羟基自由基，尤其在组织纤溶酶原激活剂（tPA）溶栓治疗中有用。依达拉奉与tPA联合治疗可大大提高中风动物的存活率，减小梗死面积，并抑制脂质、蛋白质和DNA氧化损伤的分子标志物。使用依达拉奉可大大减少tPA治疗伴随的出血转化，并且在人类中风患者中，依达拉奉还可能将tPA治疗的治疗时间窗延长超过3小时。
