轻型脑卒中溶栓治疗的研究进展与展望OA

Minor stroke is a common subtype of acute ischemic stroke,primarily defined by a National Institutes of Health Stroke Scale score≤3 or≤5.Despite mild clinical symptoms,it carries a risk of early deterioration,and its intrave-nous thrombolysis strategy has long been controversial.This article systematically summarizes the results of key random-ized controlled trials in recent years,which found that although non-inferiority has been confirmed among thrombolytic agents such as alteplase,tenecteplase,and prourokinase,none of these have shown superior functional improvement in the treatment of minor stroke compared with dual antiplatelet therapy or aspirin monotherapy,and they carry safety risks such as symptomatic intracranial hemorrhage.Subgroup analyses suggested potential benefits for patients with a National Institutes of Health Stroke Scale score>3,disabling symptoms,or the large artery atherosclerosis subtype,but the evi-dence is inconsistent.The limited net benefit of thrombolysis is primarily attributed to heterogeneous definitions,a gener-ally favorable natural prognosis,and the offsetting effect of bleeding risks.Future studies should focus on unifying defini-tions,leveraging multimodal imaging for precise patient selection,optimizing drug regimens,and ultimately achieving pre-cise stratification and individualized thrombolytic interventions for minor stroke.