BRAIN and NERVE－神経研究の進歩61巻1号

2009年01月発行

総説

組織プラスミノーゲンアクチベーター（t-PA）静注による血栓溶解療法―現状と将来展望

著者： 棚橋紀夫¹

所属機関： ¹埼玉医科大学国際医療センター神経内科・脳卒中内科

ページ範囲：P.41 - P.52

文献概要

はじめに

　脳卒中による死亡者は，わが国では年間約13万人で死因の第3位であるが，脳卒中罹患患者は272万人と推定されている^1）。脳卒中は高齢者に多い疾患であり，高齢者の寝たきり原因の最大の原因である。脳卒中のうち，脳梗塞はその3/4を占め最も多い。脳梗塞の急性期治療は，血栓溶解療法，脳浮腫治療薬，抗凝固療法，抗血小板療法，脳保護薬などがあり，これらの治療法が，発症後経過時間，重症度，臨床病型などを参考に選択される^2）。複数の治療法が併用される場合が多い。これらの治療法のうち最も効果が期待されるのが組織プラスミノーゲンアクチベーター（t-PA）静注による血栓溶解療法であるが，出血性合併症のリスクもあるため厳格に症例を選択することが求められている^3，4）。本稿では，t-PA静注療法の現状と問題点，将来展望について解説する。

参考文献

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