Fisher M, Bogousslavsky J
Department of Neurology, Medical Center of Central Massachusetts, Worcester 01605.
JAMA. 1993 Jul 21;270(3):360-4.
Acute ischemic stroke is a common, devastating disorder without beneficial therapy. Recent advances concerning the pathophysiology of ischemic brain injury have led to the development of rational pharmacological interventions. Thrombolytic and cytoprotective therapies may be useful and are being evaluated in clinical trials. The design of adequate clinical trials to evaluate these promising therapies has also evolved based on experience. Potential therapy for acute ischemic stroke must be assessed in a large number of patients who are given the intervention within hours of onset using a neurological scoring scale and a disability scale. Several new magnetic resonance imaging technologies are emerging that should allow the clinician to rapidly and accurately identify ischemic brain lesions and to evaluate cerebral perfusion. The availability of potentially efficacious therapies for ischemic stroke evaluated in well-designed clinical trials with magnetic resonance imaging technology, which can also assess therapeutic effects in vivo, should lead to the emergence of therapy to improve the outcome of patients with ischemic stroke in the near future.
急性缺血性中风是一种常见的、具有毁灭性的疾病，目前尚无有效的治疗方法。近年来，有关缺血性脑损伤病理生理学的进展促使了合理的药物干预措施的发展。溶栓和细胞保护疗法可能有效，目前正在临床试验中进行评估。基于经验，评估这些有前景疗法的充分临床试验设计也在不断发展。对于急性缺血性中风的潜在疗法，必须在大量患者中进行评估，这些患者在发病数小时内接受干预，并使用神经学评分量表和残疾量表。几种新的磁共振成像技术正在出现，这将使临床医生能够快速、准确地识别缺血性脑损伤并评估脑灌注。在精心设计的临床试验中，利用磁共振成像技术评估的缺血性中风潜在有效疗法的可用性，该技术还可以在体内评估治疗效果，这将在不久的将来促使改善缺血性中风患者预后的疗法出现。
