{"id":39769,"date":"2024-08-17T05:10:18","date_gmt":"2024-08-17T05:10:18","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=39769"},"modified":"2024-08-17T05:10:18","modified_gmt":"2024-08-17T05:10:18","slug":"%e9%87%8d%e7%a3%85%ef%bc%81%e4%b8%ad%e5%9b%bd%e6%80%a5%e6%80%a7%e7%bc%ba%e8%a1%80%e6%80%a7%e5%8d%92%e4%b8%ad%e8%af%8a%e6%b2%bb%e6%8c%87%e5%8d%97-2023-%e7%89%88%e5%8f%91%e5%b8%83%ef%bc%8c%e6%9b%b4","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=39769","title":{"rendered":"\u91cd\u78c5\uff01\u4e2d\u56fd\u6025\u6027\u7f3a\u8840\u6027\u5352\u4e2d\u8bca\u6cbb\u6307\u5357 2023 \u7248\u53d1\u5e03\uff0c\u66f4\u65b0\u8981\u70b9\u62a2\u5148\u770b\uff01"},"content":{"rendered":"

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1<\/p>\n

\u5352\u4e2d\u6551\u6cbb\u4f53\u7cfb<\/p>\n

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2<\/p>\n

\u6025\u6027\u671f\u8bc4\u4f30\u4e0e\u8bca\u65ad<\/p>\n

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3<\/p>\n

\u6025\u6027\u671f\u6cbb\u7597<\/p>\n

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\u7ea7\u8bc1\u636e\u3011\u30026\uff09\u5bf9\u4e8e\u524d\u5faa\u73af\u5927\u52a8\u8109\u95ed\u585e\u60a3\u8005\uff0c\u5982\u5e74\u9f84 \u2265 18 \u5c81\u3001NIHSS \u8bc4\u5206 \u2265 6 \u5206\u3001ASPECTS \u2265 6 \u5206\u3001\u52a8\u8109\u7a7f\u523a\u65f6\u95f4\u80fd\u591f\u63a7\u5236\u5728\u53d1\u75c5\u540e 6 h \u5185\uff0c\u63a8\u8350\u673a\u68b0\u53d6\u6813\u6cbb\u7597\u3010\u2160 \u7ea7\u63a8\u8350\uff0cA \u7ea7\u8bc1\u636e\u3011\u30027\uff09\u5bf9\u524d\u5faa\u73af\u5927\u52a8\u8109\u95ed\u585e\u7684\u8111\u6897\u6b7b\u60a3\u8005\uff0c\u5982\u53d1\u75c5 6\uff5e16 h \u5185\u4e14\u7b26\u5408 DAWN \u6216 DEFUSE-3 \u6807\u51c6\uff0c\u63a8\u8350\u673a\u68b0\u53d6\u6813\u6cbb\u7597 (\u2160 \u7ea7\u63a8\u8350\uff0cA \u7ea7\u8bc1\u636e\uff09\uff1b\u5982\u53d1\u75c5 16\uff5e24 h \u5185\u4e14\u7b26\u5408 DAWN \u6807\u51c6\uff0c\u53ef\u91c7\u7528\u673a\u68b0\u53d6\u6813\u6cbb\u7597\u3010\u2161 \u7ea7\u63a8\u8350\uff0cB \u7ea7\u8bc1\u636e\u3011\u30028\uff09\u5bf9\u4e8e\u524d\u5faa\u73af\u5927\u52a8\u8109\u95ed\u585e\u7684\u5927\u6897\u6b7b\u6838\u5fc3\u60a3\u8005\uff0c\u5982\u53d1\u75c5 24 h \u5185 ASPECTS 3\uff5e5 \u5206\uff0c\u8c28\u614e\u8bc4\u4f30\u83b7\u76ca\u548c\u98ce\u9669\u540e\uff0c\u53ef\u9009\u62e9\u6027\u7ed9\u4e88\u673a\u68b0\u53d6\u6813\u6cbb\u7597 (\u2160 \u7ea7\u63a8\u8350\uff0cA \u7ea7\u8bc1\u636e\uff09\uff1b\u5982\u53d1\u75c5 24 h \u5185\u6897\u6b7b\u6838\u5fc3 50\uff5e100 mL\uff0c\u53ef\u7ed9\u4e88\u673a\u68b0\u53d6\u6813\u6cbb\u7597\u3010\u2161 \u7ea7\u63a8\u8350\uff0cB \u7ea7\u8bc1\u636e\u3011\u30029\uff09\u5bf9\u5e74\u9f84 18\uff5e80 \u5c81\u3001NHISS \u8bc4\u5206 \u2265 6 \u5206\u3001\u540e\u5faa\u73af ASPECTS \u2265 6 \u5206\u3001\u53d1\u75c5 12 h \u5185\u7684\u57fa\u5e95\u52a8\u8109\u95ed\u585e\u6025\u6027\u7f3a\u8840\u6027\u5352\u4e2d\u60a3\u8005\uff0c\u63a8\u8350\u673a\u68b0\u53d6\u6813\u6cbb\u7597\u3010\u2160 \u7ea7\u63a8\u8350\uff0cA \u7ea7\u8bc1\u636e\u3011\uff1b\u5bf9\u53d1\u75c5 12\uff5e24 h \u690e\u57fa\u5e95\u52a8\u8109\u95ed\u585e\u60a3\u8005\uff0c\u8c28\u614e\u8bc4\u4f30\u83b7\u76ca\u548c\u98ce\u9669\u540e\uff0c\u53ef\u8003\u8651\u673a\u68b0\u53d6\u6813\u6cbb\u7597\u3010\u2161 \u7ea7\u63a8\u8350\uff0cB \u7ea7\u8bc1\u636e\u3011\u300210\uff09\u5bf9\u4e8e\u540c\u65f6\u5b58\u5728\u9885\u5185\u548c\u9885\u5916\u8840\u7ba1\u95ed\u585e\u7684\u4e32\u8054\u75c5\u53d8\u60a3\u8005\u6216\u673a\u68b0\u53d6\u6813\u540e\u518d\u901a\u8840\u7ba1\u5b58\u5728\u660e\u663e\u72ed\u7a84\u7684\u60a3\u8005\uff0c\u6025\u8bca\u884c\u652f\u67b6\u7f6e\u5165\u672f\u6216\u8840\u7ba1\u6210\u5f62\u672f\u7684\u6709\u6548\u6027\u6709\u5f85\u8fdb\u4e00\u6b65\u7814\u7a76\uff1b\u4e34\u5e8a\u4e0a\u53ef\u4ed4\u7ec6\u6743\u8861\u83b7\u76ca\u98ce\u9669\u540e\uff0c\u4e2a\u4f53\u5316\u51b3\u7b56\u3010\u2162 \u7ea7\u63a8\u8350\uff0cC \u7ea7\u8bc1\u636e\u3011\uff082018 \u7248\u6307\u5357\uff1a\u9650\u4e8e\u4e34\u5e8a\u8bd5\u9a8c\u73af\u5883\u4e0b\u4f7f\u7528\uff09\u300211\uff09\u5bf9\u4e8e\u673a\u68b0\u53d6\u6813\u672a\u80fd\u5b9e\u73b0\u8840\u7ba1\u518d\u901a\u7684\u5927\u52a8\u8109\u95ed\u585e\u60a3\u8005\uff0c\u8fdb\u884c\u52a8\u8109\u6eb6\u6813\uff08\u53d1\u75c5 6 h \u5185\uff09\u4f5c\u4e3a\u8865\u5145\u6cbb\u7597\u53ef\u80fd\u662f\u5408\u7406\u7684\u3010\u2161 \u7ea7\u63a8\u8350\uff0cB \u7ea7\u8bc1\u636e\u3011\uff08\u540c 2018 \u7248\u8868\u8ff0\u7565\u6709\u5dee\u5f02\u4f46\u57fa\u672c\u4e00\u81f4\uff09\u3002\u5bf9\u4e8e\u5927\u52a8\u8109\u95ed\u585e\u6027\u6025\u6027\u7f3a\u8840\u6027\u5352\u4e2d\u60a3\u8005\uff0c\u673a\u68b0\u53d6\u6813\u4e14\u8840\u7ba1\u518d\u901a\u540e\u5e94\u7528\u52a8\u8109\u6eb6\u6813\u4f5c\u4e3a\u8f85\u52a9\u6cbb\u7597\u7684\u7597\u6548\u6709\u5f85\u8fdb\u4e00\u6b65\u7814\u7a76\u3010\u2161 \u7ea7\u63a8\u8350\uff0cB \u7ea7\u8bc1\u636e\u3011\u300204\u3001\u6297\u8840\u5c0f\u677f\u6cbb\u7597\u65b0\u65e7\u7248\u6307\u5357\u7684\u63a8\u8350\u57fa\u672c\u4e00\u81f4\uff0c2023 \u7248\u6307\u5357\u6709\u5982\u4e0b\u66f4\u65b0\uff1a1\uff09\u5728\u9488\u5bf9\u53d1\u75c5 24 \u5c0f\u65f6\u5185\u7684\u8f7b\u578b\u5352\u4e2d\u8fdb\u884c\u53cc\u6297\u8840\u5c0f\u677f\u7684\u63a8\u8350\u65f6\u589e\u52a0\u4e86\u57fa\u56e0\u68c0\u6d4b\u7684\u5185\u5bb9\uff1a\u5982\u60a3\u8005\u5df2\u5b8c\u6210 CYP2C19 \u57fa\u56e0\u68c0\u6d4b\uff0c\u4e14\u4e3a CYP2C19 \u529f\u80fd\u7f3a\u5931\u7b49\u4f4d\u57fa\u56e0\u643a\u5e26\u8005\uff0c\u53ef\u4f7f\u7528\u66ff\u683c\u745e\u6d1b\u548c\u963f\u53f8\u5339\u6797\u53cc\u91cd\u6297\u8840\u5c0f\u677f\u6cbb\u7597\u5e76\u7ef4\u6301 21 d\u3010\u2161 \u7ea7\u63a8\u8350\uff0cB \u7ea7\u8bc1\u636e\u3011\u30022\uff09\u63d0\u9ad8\u4e86\u8840\u7ba1\u5185\u673a\u68b0\u53d6\u6813\u540e 24 h \u5185\u4f7f\u7528\u66ff\u7f57\u975e\u73ed\u7684\u63a8\u8350\u7ea7\u522b\u3010\u2161 \u7ea7\u63a8\u8350\uff0cC \u7ea7\u8bc1\u636e\u3011\uff082018 \u7248\u6307\u5357\u4e3a \u2162 \u7ea7\u63a8\u8350\uff0cC \u7ea7\u8bc1\u636e\uff09\u30023\uff092023 \u7248\u6307\u5357\u5220\u9664\u4e86 2018 \u7248\u6307\u5357\u4e2d\u7684\u63a8\u8350\u610f\u89c1\uff1a\u4e34\u5e8a\u7814\u7a76\u672a\u8bc1\u5b9e\u66ff\u683c\u745e\u6d1b\u6cbb\u7597\u8f7b\u578b\u5352\u4e2d\u4f18\u4e8e\u963f\u53f8\u5339\u6797\uff0c\u4e0d\u63a8\u8350\u66ff\u683c\u745e\u6d1b\u66ff\u4ee3\u963f\u53f8\u5339\u6797\u7528\u4e8e\u8f7b\u578b\u5352\u4e2d\u7684\u6025\u6027\u671f\u6cbb\u7597\u3002\u66ff\u683c\u745e\u6d1b\u7684\u5b89\u5168\u751f\u4e0e\u963f\u53f8\u5339\u6797\u76f8\u4f3c\uff0c\u8981\u8003\u8651\u4f5c\u4e3a\u6709\u963f\u53f8\u5339\u6797\u7981\u5fcc\u75c7\u7684\u66ff\u4ee3\u836f\u7269\u3002>> \u6700\u65b0 CHANCE-2 \u7814\u7a76\u7ed3\u679c\u663e\u793a\u5728\u643a\u5e26\u6709 CYP2C19 \u529f\u80fd\u7f3a\u5931\u7b49\u4f4d\u57fa\u56e0\u7684\u8f7b\u578b\u5352\u4e2d\u60a3\u8005\u4e2d\uff0c\u65e9\u671f\uff08\u53d1\u75c5\u540e 24 h \u5185\uff09\u66ff\u683c\u745e\u6d1b\u8054\u5408\u963f\u53f8\u5339\u6797\uff08\u66ff\u683c\u745e\u6d1b\u9996\u65e5\u8d1f\u8377\u5242\u91cf  180 mg\uff0c\u6b64\u540e 90 mg  2 \u6b21\/d\uff0c\u8054\u5408\u963f\u53f8\u5339\u6797 75 mg\/d\uff0c \u5e94\u7528 21 d \u540e\u6539\u4e3a\u5355\u836f\u66ff\u683c\u745e\u6d1b\uff09\u9884\u9632 90 d \u5352\u4e2d\u590d\u53d1\u7684\u7597\u6548\u4f18\u4e8e\u6c2f\u5421\u683c\u96f7\u8054\u5408\u963f\u53f8\u5339\u6797\uff0c\u4e14\u4e24\u7ec4\u4e4b\u95f4\u7684\u4e25\u91cd\u51fa\u8840\u98ce\u9669\u7c7b\u4f3c\u30024\uff09\u63d0\u9ad8\u4e86\u8840\u7ba1\u5185\u673a\u68b0\u53d6\u6813\u540e 24 h \u5185\u4f7f\u7528\u66ff\u7f57\u975e\u73ed\u7684\u63a8\u8350\u7b49\u7ea7\u3010\u2161 \u7ea7\u63a8\u8350\uff0cC \u7ea7\u8bc1\u636e\u3011\uff082018 \u7248\u6307\u5357\uff1a\u2162 \u7ea7\u63a8\u8350\uff0cC \u7ea7\u8bc1\u636e\uff09\u5e76\u589e\u52a0\u4e86\u63a8\u8350\u5185\u5bb9\uff1a\u5bf9\u4e8e\u6025\u6027\u975e\u5927-\u4e2d\u52a8\u8109\u95ed\u585e\u6027\u81f4\u6b8b\u6027\u7f3a\u8840\u6027\u5352\u4e2d\u60a3\u8005\uff08\u53d1\u75c5 24 h \u5185\u4e0d\u5b9c\u8fdb\u884c\u9759\u8109\u6eb6\u6813\u6216\u8840\u7ba1\u5185\u673a\u68b0\u53d6\u6813\u6cbb\u7597\u6216\u53d1\u75c5\u540e 24\uff5e96 h \u5185\u75c7\u72b6\u8fdb\u5c55\uff1b\u6216\u9759\u8109\u6eb6\u6813\u540e\u51fa\u73b0\u65e9\u671f\u75c7\u72b6\u52a0\u91cd\u6216\u9759\u8109\u6eb6\u6813\u6cbb\u7597\u540e 4\uff5e24 h \u5185\u75c7\u72b6\u65e0\u6539\u5584\uff09\uff0c\u9759\u8109\u4f7f\u7528\u66ff\u7f57\u975e\u73ed\u53ef\u6539\u5584\u9884\u540e\uff0c\u4f46\u75c7\u72b6\u6027\u9885\u5185\u51fa\u8840\u8f7b\u5ea6\u589e\u52a0\uff0c\u4e34\u5e8a\u533b\u5e08\u9700\u5145\u5206\u8bc4\u4f30\u83b7\u76ca\u548c\u51fa\u8840\u98ce\u9669\u3010\u2161 \u7ea7\u63a8\u8350\uff0cB \u7ea7\u8bc1\u636e\u3011\u300205\u3001\u6297\u51dd\u6cbb\u7597\u4e24\u7248\u6307\u5357\u63a8\u8350\u610f\u89c1\u57fa\u672c\u4e00\u81f4\uff0c\u5bf9\u5927\u591a\u6570\u6025\u6027\u7f3a\u8840\u6027\u5352\u4e2d\u60a3\u8005\uff0c\u4e0d\u63a8\u8350\u65e0\u9009\u62e9\u5730\u65e9\u671f\u8fdb\u884c\u6297\u51dd\u6cbb\u7597\u3010\u2160 \u7ea7\u63a8\u8350\uff0cA \u7ea7\u8bc1\u636e\u3011\u30022023 \u7248\u6307\u5357\u65b0\u589e\u4e86\u5352\u4e2d\u540e\u65e9\u671f\u4f7f\u7528\u65b0\u578b\u6297\u51dd\u5242\u7684\u63a8\u8350\uff1a\u5bf9\u4e8e\u4f34\u5fc3\u623f\u98a4\u52a8\u7684\u6025\u6027\u7f3a\u8840\u6027\u5352\u4e2d\u60a3\u8005\uff0c\u65e9\u671f\u4f7f\u7528\u65b0\u578b\u6297\u51dd\u5242\u8fdb\u884c\u6297\u51dd\u662f\u5b89\u5168\u7684\uff0c\u53ef\u5728\u5145\u5206\u6c9f\u901a\uff0c\u5e76\u8bc4\u4f30\u5352\u4e2d\u590d\u53d1\u548c\u51fa\u8840\u98ce\u9669\u540e\uff0c\u5728\u5352\u4e2d\u540e\u65e9\u671f\u4e2a\u4f53\u5316\u542f\u52a8\u65b0\u578b\u6297\u51dd\u5242\u8fdb\u884c\u6297\u51dd\u3010\u2161 \u7ea7\u63a8\u8350\uff0cB \u7ea7\u8bc1\u636e\u3011\u3002\u63a8\u8350\u539f\u56e0\u662f\u56e0\u4e3a\u65b0\u8fd1\u53d1\u8868\u7684 TIMING \u548c ELAN \u7814\u7a76\u8bc1\u5b9e\u4e86\u4f34\u623f\u98a4\u7684\u6025\u6027\u7f3a\u8840\u6027\u5352\u4e2d\u60a3\u8005\u65e9\u671f\u4f7f\u7528\u65b0\u578b\u6297\u51dd\u836f\u7684\u5b89\u5168\u6027\u300206\u3001\u5176\u4ed6\u836f\u7269\u6cbb\u75972023 \u7248\u6307\u5357\u65b0\u589e\uff1a1\uff09\u6269\u8840\u7ba1\u6cbb\u7597\uff1a\u5728\u4e34\u5e8a\u5de5\u4f5c\u4e2d\uff0c\u53ef\u4f9d\u636e RCT \u7814\u7a76\u7ed3\u679c\u4e2a\u4f53\u5316\u5e94\u7528\u9a6c\u6765\u9178\u6842\u54cc\u9f50\u7279\u6ce8\u5c04\u6db2\u3010\u2161 \u7ea7\u63a8\u8350\uff0cB \u7ea7\u8bc1\u636e\u3011\uff1b2\uff09\u795e\u7ecf\u4fdd\u62a4\u5242\uff1a\u5728\u4e34\u5e8a\u5de5\u4f5c\u4e2d\uff0c\u4f9d\u636e RCT 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