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rtPA 治疗脑卒中的疗效能否提高?

Can the benefits of rtPA treatment for stroke be improved?

机构信息

Université de Normandie, UNICAEN, Inserm U1237, établissement français du sang (EFS), physiopathology and imaging of neurological disorders (PhIND), GIP Cyceron, boulevard Becquerel, BP 5229, 14074 Caen cedex, France; Department of clinical research, Caen University Hospital, CHU, avenue de-la-côte-de-Nacre, Caen, France.

出版信息

Rev Neurol (Paris). 2017 Nov;173(9):566-571. doi: 10.1016/j.neurol.2017.07.003. Epub 2017 Aug 7.

Abstract

Tissue-type plasminogen activator (tPA) is a serine protease well known to promote fibrinolysis. This is why: its recombinant form (rtPA) can be used, either alone or combined with thrombectomy, to promote recanalization/reperfusion following ischemic stroke. However, its overall benefits are counteracted by some of its side-effects, including incomplete lysis of clots, an increased risk of hemorrhagic transformation and the possibility of neurotoxicity. Nevertheless, better understanding of the mechanisms by which tPA influences brain function and promotes its alteration may help in the design of new strategies to improve stroke therapy.

摘要

组织型纤溶酶原激活物(tPA)是一种丝氨酸蛋白酶,众所周知,它可促进纤维蛋白溶解。原因如下:其重组形式(rtPA)可单独使用,也可与血栓切除术联合使用,以促进缺血性脑卒中后的再通/再灌注。然而,其整体益处被一些副作用抵消,包括血栓不完全溶解、出血性转化风险增加和神经毒性的可能性。尽管如此,更好地了解 tPA 影响大脑功能并促进其改变的机制可能有助于设计新的策略来改善脑卒中的治疗。

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