Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA.
Expert Opin Pharmacother. 2021 May;22(7):897-906. doi: 10.1080/14656566.2020.1856815. Epub 2020 Dec 31.
: For elderly adults in the United States, stroke is the fifth leading cause of death of which ischemic strokes comprise a vast majority. Optimal pharmacological management of elderly ischemic stroke patients involves both reperfusion and supportive care. Recent research into pharmacological management has focused on vascular, immunomodulatory, cytoprotective, and alternative agents, some of which have shown limited success in clinical trials. However, no treatments have been established as a reliable mode for management of cerebral ischemia for elderly adults beyond acute thrombolysis.: The authors conducted a literature search for ischemic stroke management in the elderly and a search for human drug studies for managing ischemic stroke on clinicaltrials.gov. Here, they describe recent progress in the pharmacological management of cerebral ischemia in the elderly.: Many drug classes (antihypertensive, cytoprotective and immunomodulatory, and alternative agents) have been explored with limited success in managing ischemic stroke, though some have shown preventative benefits. We generally observed a broad gap in evidence on elderly patients from studies across all drug classes, necessitating further studies to gain an understanding of effective management of ischemic stroke in this large demographic of patients.
: 对于美国的老年人来说，中风是第五大死因，其中缺血性中风占绝大多数。老年缺血性中风患者的最佳药物治疗包括再灌注和支持性治疗。最近对药物治疗的研究集中在血管、免疫调节、细胞保护和替代药物上，其中一些在临床试验中显示出有限的成功。然而，除了急性溶栓之外，没有任何治疗方法被确立为管理老年人脑缺血的可靠模式。: 作者对老年人缺血性中风的管理进行了文献检索，并在 clinicaltrials.gov 上对管理缺血性中风的人体药物研究进行了检索。在这里，他们描述了老年人脑缺血药物治疗的最新进展。: 许多药物类别（抗高血压、细胞保护和免疫调节以及替代药物）在管理缺血性中风方面的探索取得了有限的成功，尽管有些药物显示出了预防作用。我们普遍观察到，在所有药物类别中，来自老年患者的研究的证据存在很大差距，这需要进一步的研究来了解如何有效地管理这一大患者群体的缺血性中风。
