Gusev E I, Martynov M Yu, Yasamanova A N, Nikonov A A, Markin S S, Semenov A M
Pirogov Russian National Research Medical University, Moscow, Russia.
Orekhovich Institute of Biomedical Chemistry, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2018;118(12. Vyp. 2):4-14. doi: 10.17116/jnevro20181181224.
Reperfusion therapy is one of the main treatment strategies of ischemic stroke. The first studies of the efficacy of thrombolytic medications started form the use of streptokinase and fibrinolysin in patients with ischemic stroke in late 50 - early 60 of the XX century in the United States, Soviet Union, and Western Europe. After the development of recombinant tissue plasminogen activator, thrombolysis became one of the main methods of reperfusion in patients with acute ischemic stroke, acute myocardial infarction, or other acute vascular thrombotic events. Later, modified variants of tissue plasminogen activator with prolonged clearance time, high fibrin-selectivity, and bolus delivery were introduced. Another group of thrombolytic agents includes derivatives of flora and fauna - external plasminogen activators, of which streptokinase, staphylokinase, and desmoteplase are most common drugs. These medications are not a structural part of the human organism, and overcoming of immunogenicity while preserving fibrinolytic activity and fibrin specificity is one of the main tasks in applying them in clinical practice.
再灌注治疗是缺血性卒中的主要治疗策略之一。20世纪50年代末至60年代初，在美国、苏联和西欧，最早关于溶栓药物疗效的研究始于在缺血性卒中患者中使用链激酶和纤维蛋白溶酶。重组组织型纤溶酶原激活剂研发出来后，溶栓成为急性缺血性卒中、急性心肌梗死或其他急性血管血栓形成事件患者再灌注的主要方法之一。后来，又引入了清除时间延长、纤维蛋白选择性高且可推注给药的组织型纤溶酶原激活剂改良变体。另一类溶栓药物包括动植物来源的纤溶酶原激活剂，其中链激酶、葡萄球菌激酶和去氨普酶是最常用的药物。这些药物并非人体结构的一部分，在临床应用中，在保留纤溶活性和纤维蛋白特异性的同时克服免疫原性是主要任务之一。
