中国神经再生研究(英文版) ›› 2015, Vol. 10 ›› Issue (8): 1186-1190.doi: 10.4103/1673-5374.162687

• 综述:脑损伤修复保护与再生 • 上一篇    下一篇

经颅激光与静脉注射tPA治疗急性缺血性脑损伤的神经免疫调节

  

  • 收稿日期:2015-05-20 出版日期:2015-08-24 发布日期:2015-08-24

Neuroimmunomodulatory effects of transcranial laser therapy combined with intravenous tPA administration for acute cerebral ischemic injury

Philip V. Peplow   

  1. Department of Anatomy, University of Otago, Dunedin, New Zealand
  • Received:2015-05-20 Online:2015-08-24 Published:2015-08-24
  • Contact: Philip V. Peplow, Ph.D., phil.peplow@stonebow.otago.ac.nz.

摘要:

目前唯一被FDA批准用于治疗缺血性脑卒中的是在脑卒中发作后4.5小时内组织型纤溶酶原激活剂(tPA)静脉给药。由于这种短暂的治疗时间窗,只有少数患者能够接受tPA治疗。颅激光治疗已被证明在急性缺血性脑卒中动物模型中有效,并且神经学评分和功能均有显著改善。人类患者研究也已经证实了颅激光治疗对的缺血性脑卒中治疗的安全性和有效性,并在脑卒中发作24小时内有效。此外,颅激光治疗与静脉注射tPA的结合治疗可能会提供更好的结果。

Abstract:

At present, the only FDA approved treatment for ischemic strokes is intravenous administration of tissue plasminogen activator within 4.5 hours of stroke onset. Owing to this brief window only a small percentage of patients receive tissue plasminogen activator. Transcranial laser therapy has been shown to be effective in animal models of acute ischemic stroke, resulting in significant improvement in neurological score and function. NEST-1 and NEST-2 clinical trials in human patients have demonstrated the safety and positive trends in efficacy of transcranial laser therapy for the treatment of ischemic stroke when initiated close to the time of stroke onset. Combining intravenous tissue plasminogen activator treatment with transcranial laser therapy may provide better functional outcomes. Statins given within 4 weeks of stroke onset improve stroke outcomes at 90 days compared to patients not given statins, and giving statins following transcranial laser therapy may provide an effective treatment for patients not able to be given tissue plasminogen activator due to time constraints.

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