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急性缺血性卒中溶栓药物的研究进展
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| 篇名： | 急性缺血性卒中溶栓药物的研究进展 |
| TITLE： | Research progress of thrombolytic drugs for acute ischemic stroke |
| 摘要： | 急性缺血性卒中是一种发病率、致死率、致残率、复发率均较高的脑血管疾病，严重危害患者的健康。溶栓药物通过激活纤维蛋白溶酶原（简称“纤溶酶原”），来快速溶解血栓，减少血小板聚集，实现血管成功再通，对急性缺血性卒中的治疗具有关键作用。本研究基于当前国内外研究，从溶栓药物的作用原理及分类运用等方面进行综述。结果发现，从不具有纤维蛋白特异性的第一代溶栓药物链激酶，到第三代溶栓药物替奈普酶，第三代溶栓药物既保留了直接活化纤溶酶原的特性，还增强了纤维蛋白特异性，延长了半衰期，有效性和安全性更好。随着研究的发展，具有纤溶酶原激活物抑制作用的小分子化合物，或者改造具有较强体内抗纤溶酶原激活物抑制活性的溶栓药物，或者从微生物、天然植物中寻找新型的具有溶栓作用的小分子物质，成为了新型溶栓药物研究的热点。新型溶栓药物可能因具有更强的溶栓效率和更少的副作用，而成为当前溶栓治疗的替代药物。 |
| ABSTRACT： | Acute ischemic stroke is a cerebrovascular disease with high incidence， high mortality and disability， and high recurrence rate， which seriously endangers patients’ health. Thrombolytic drugs play a key role in the treatment of acute ischemic stroke by activating plasminogen， rapidly dissolving thrombi， reducing platelet aggregation， and achieving successful recanalization. In this study， we reviewed the principle of action of thrombolytic drugs， their classification and use on the basis of current research progress at home and abroad. The results show that the safety and efficacy of thrombolytic drugs have improved significantly from the first generation of thrombolytic drugs， streptokinase， which is not fibrin-specific， to the third generation of thrombolytic drugs， tenecteplase， which not only retain the characteristics of directly activating plasminogen， but also enhance the specificity of fibrin and prolong the half-life. With the development of research， small-molecular compounds with the inhibition of plasminogen activator， or the modification of thrombolytic drugs with strong anti-plasminogen activator inhibition activity in vivo， or the search for new small-molecular substances with thrombolytic effect from microorganisms and natural plants， have become the focus of research on new thrombolytic drugs. The new thrombolytic drugs are likely to replace the current thrombolytic drugs because of greater thrombolytic efficacy and fewer side effects. |
| 期刊： | 2023年第34卷第04期 |
| 作者： | 孔维麟；杨清武 |
| AUTHORS： | KONG Weilin，YANG Qingwu |
| 关键字： | 急性缺血性卒中；溶栓药物；纤溶酶原激活物 |
| KEYWORDS： | acute ischemic stroke； thrombolytic drug； plasminogen activator |
| 阅读数： | 186 次 |
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