Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa Hospitals and Clinics Stroke Center, University of Iowa, Iowa City, IA.
Ann Neurol. 2013 Jul;74(1):4-10. doi: 10.1002/ana.23948. Epub 2013 Aug 6.
Approximately 700,000 people in the United States have an ischemic stroke annually. Substantial research has tested therapies for the very early treatment of ischemic stroke but, to date, only intravenous thrombolysis and intra-arterial measures to restore perfusion have shown success. Despite a 15-year effort to increase the use of these therapies, only approximately 5% of patients with stroke are currently being treated. Although most patients with stroke have some neurological recovery, more than half of stroke survivors have residual impairments that lead to disability or long-term institutionalized care. Laboratory research has demonstrated several mechanisms that help the brain to recover after a stroke. New pharmacological and cell-based approaches that are known to promote brain plasticity are emerging from laboratory studies and may soon expand the window for stroke treatment to restore function. It is time to build on this knowledge and to translate the understanding of recovery after stroke into the clinical setting. Measures that might augment recovery should become a major focus of clinical research in stroke in the 21st century.
每年，美国约有 70 万人患有缺血性中风。大量研究已经测试了缺血性中风的早期治疗方法，但迄今为止，只有静脉溶栓和恢复灌注的动脉内措施显示出成功。尽管经过 15 年的努力来增加这些治疗方法的应用，但目前只有约 5%的中风患者得到了治疗。尽管大多数中风患者有一定程度的神经恢复，但超过一半的中风幸存者仍有残留的损伤，导致残疾或长期住院护理。实验室研究已经证明了几种有助于中风后大脑恢复的机制。从实验室研究中涌现出了一些已知可促进大脑可塑性的新的药理学和基于细胞的方法，它们可能很快会扩大中风治疗以恢复功能的时间窗口。现在是时候在这一知识的基础上，将中风后恢复的认识转化为临床实践了。在 21 世纪，提高恢复能力的措施应该成为中风临床研究的主要重点。
