Research progress and prospects of thrombolytic therapy for minor stroke
10.19845/j.cnki.zfysjjbzz.2026.0035
- VernacularTitle:轻型脑卒中溶栓治疗的研究进展与展望
- Author:
Rumei LEI
1
;
Shuai JIANG
1
Author Information
1. Department of Neurology， West China Hospital，Sichuan University， Chengdu， 610041， China; Center of Cerebrovascular Diseases， West China Hospital，University， Chengdu， Sichuan 610041， China
- Publication Type:Journal Article
- Keywords:
Minor stroke;
Intravenous thrombolysis;
Randomized controlled trial
- From:
Journal of Apoplexy and Nervous Diseases
2026;43(3):199-203
- CountryChina
- Language:Chinese
-
Abstract:
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 intravenous thrombolysis strategy has long been controversial. This article systematically summarizes the results of key randomized 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 evidence is inconsistent. The limited net benefit of thrombolysis is primarily attributed to heterogeneous definitions， a generally favorable natural prognosis， and the offsetting effect of bleeding risks. Future studies should focus on unifying definitions， leveraging multimodal imaging for precise patient selection， optimizing drug regimens， and ultimately achieving precise stratification and individualized thrombolytic interventions for minor stroke.
- Full text:2026060914582245219轻型脑卒中溶栓治疗的研究进展与展望.pdf
