Development and prospect of intravenous thrombolytic drugs for ischemic stroke

Ischemic stroke refers to the necrosis of brain tissue caused by the narrowing or occlusion of the supplied arteries of the brain, which can lead to disability or death, and is one of the main causes of death of residents in
China.

1 Development of thrombolytic drugs

Blood clots in the human body are mainly composed
of fibrin, platelets, white blood cells, red blood cells and so on.

Ideal thrombolytic agents should have the following characteristics: fibrin specificity, resistance to PAI-1, high retransmission rate, low recurrence rate, low bleeding rate, no antigenicity, easy to use, and cost-effective
.

The first generation of thrombolytic drugs has no fibrin specificity, and the representative drug is urokinase
.

2 urokinase

The basis for the use of urokinase in China is mainly from the "Ninth Five-Year Plan" research topic "Intravenous thrombolytic therapy of urokinase within 6 hours of acute ischemic stroke"
.

In foreign countries, urokinase has not been licensed
for use in thrombolytic acute ischemic stroke.

3 alteplase

Alteplase is the first acute ischemic stroke thrombolytic drug approved by the U.

In the US 2019 guidelines, the time range of occurrence of alteplase for the treatment of ischemic stroke is 4.

4 tenectase

Theoretically, tenectase has higher specificity and longer half-lives than alteplase, and the efficacy and safety of thrombolysis should be better
.

In the US 2019 Stroke Acute Phase Guidelines, in some cases, it is recommended that teneplase can replace alteplase
.

5 Outlook

In the treatment of acute ischemic stroke, thrombolytic therapy is the most important treatment
.