低剂量阿替普酶溶栓治疗急性缺血性脑卒中研究进展

Research progress of low-dose alteplase in the treatment of acute ischemic stroke

关键词:  急性缺血性脑卒中  阿替普酶  低剂量  静脉溶栓

Key words:  acute ischemic stroke  alteplase  low-dose  intravenous thrombolysis

摘要:

阿替普酶静脉溶栓是目前医治急性缺血性脑卒中的最佳措施。虽然各大指南推荐的阿替普酶应用剂量为0.9 mg/kg（最大剂量90 mg），但近年来越来越多的观察性研究认为，低剂量阿替普酶（0.6 mg/kg）溶栓治疗可取得与标准剂量同样的疗效，并可减少症状性颅内出血的发生，不过目前循证医学证据不足。本文围绕低剂量阿替普酶治疗急性缺血性脑卒中现有研究进行综合阐述，希望为临床医生提供参考。

Abstract:

Intravenous thrombolysis with alteplase is the best treatment for acute ischemic stroke. Although the recommended dosage of alteplase in the major guidelines is 0.9 mg/kg (maximum dose 90 mg), more and more observational studies in recent years believe that low-dose alteplase (0.6 mg/kg) thrombolytic therapy can achieve the same effect of the standard dose and decrease the occurrence of symptomatic intracranial hemorrhage. However, the data in the current evidence-based medicine is insufficient. This article focuses on the existing research of low-dose alteplase in the treatment of acute ischemic stroke, hoping to provide reference for clinicians.