Department of Internal Medicine, University Hospital of Saarland, Homburg/Saar, Germany.
Clin Interv Aging. 2013;8:963-74. doi: 10.2147/CIA.S48269. Epub 2013 Jul 24.
Alteplase has traditionally been the only pharmacologic agent available for treating acute ischemic stroke worldwide, and is considered an effective and safe therapeutic drug for acute cerebral ischemia. However, the drug is usually indicated for use in patients aged <81 years due to insufficient literature regarding the drug's safety in older individuals. Nevertheless, the elderly can benefit from alteplase after they experience an acute ischemic stroke. Age differences have been observed in the clinical presentation of acute ischemic stroke; however, the safety and efficacy of alteplase for patients with acute ischemic stroke do not depend on age or sex. Evidence of an increasing rate of intracerebral hemorrhage among the elderly with acute ischemic stroke, following alteplase treatment, has not been reported. Severe intracranial hemorrhage is a known side effect of alteplase but is not associated with age in patients with acute ischemic stroke. Alteplase can be used safely and effectively to treat elderly patients who suffer an acute ischemic stroke, including those over the age of 80 years.
阿替普酶一直以来是全世界治疗急性缺血性脑卒中的唯一药物，被认为是治疗急性脑缺血的有效且安全的治疗药物。但是，由于老年人用药的安全性相关文献不足，该药物通常只适用于 <81 岁的患者。然而，老年人在发生急性缺血性脑卒中后也可以从阿替普酶中获益。急性缺血性脑卒中的临床表现存在年龄差异；然而，阿替普酶治疗急性缺血性脑卒中患者的安全性和疗效并不取决于年龄或性别。阿替普酶治疗后，老年急性缺血性脑卒中患者颅内出血发生率增加的证据尚未报道。严重颅内出血是阿替普酶的已知副作用，但与急性缺血性脑卒中患者的年龄无关。阿替普酶可安全有效地用于治疗老年急性缺血性脑卒中患者，包括 80 岁以上的患者。
