切换至 "中华医学电子期刊资源库"

中华脑血管病杂志(电子版) ›› 2026, Vol. 20 ›› Issue (04) : 455 -461. doi: 10.3877/cma.j.issn.1673-9248.2026.04.015

综述

依达拉奉右莰醇在急性缺血性脑卒中的临床应用进展
黄开来1,2, 李威1,2, 赵振强1,2,()   
  1. 1 570102 海南海口,海南医科大学第一附属医院生殖健康及相关疾病研究与转化教育部重点实验室
    2 570102 海南海口,海南医科大学第一附属医院神经内科
  • 收稿日期:2026-07-06 出版日期:2026-08-01
  • 通信作者: 赵振强
  • 基金资助:
    国家自然科学基金(81860238); 中国青年创业就业基金会中国青年医学创新研究科研课题(20251202-01); 海南省外国专家项目任务书(G20241024014E)

Clinical advances of edaravone dexborneol in the treatment of acute ischemic stroke

Kailai Huang1,2, Wei Li1,2, Zhenqiang Zhao1,2,()   

  1. 1 Key Laboratory of Reproductive Health Diseases Research and Translation of Ministry of Education,the First Affiliated Hospital, Hainan Medical University, Haikou 570102, China
    2 Department of Neurology, the First Affiliated Hospital, Hainan Medical University, Haikou 570102, China
  • Received:2026-07-06 Published:2026-08-01
  • Corresponding author: Zhenqiang Zhao
引用本文:

黄开来, 李威, 赵振强. 依达拉奉右莰醇在急性缺血性脑卒中的临床应用进展[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(04): 455-461.

Kailai Huang, Wei Li, Zhenqiang Zhao. Clinical advances of edaravone dexborneol in the treatment of acute ischemic stroke[J/OL]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2026, 20(04): 455-461.

急性缺血性脑卒中(AIS)的致残率与病死率均居高不下。在缺血发生后,氧化应激、神经炎症、兴奋性氨基酸毒性及血脑屏障破坏等多种缺血级联反应相互交织,构成AIS复杂的病理生理过程。静脉溶栓和血管内治疗虽可改善AIS患者的预后,但治疗时间窗狭窄,缺血再灌注损伤难以避免,导致部分患者的临床获益仍然有限。依达拉奉右莰醇是由依达拉奉与右莰醇按4∶1比例组成的复方神经保护剂,其抗氧化与抗炎双靶点同步起效,发挥脑保护作用。本文围绕依达拉奉右莰醇的药理学机制、临床研究证据(包含随机对照试验与真实世界研究)、联合治疗策略、特殊脑卒中亚型应用及未来研究方向等进行综述,并探讨个体化精准用药方向,为临床合理应用提供参考。

Acute ischemic stroke (AIS) remains a leading cause of long-term disability and mortality. The pathophysiological process of AIS is driven by a complex, intertwined ischemic cascade encompassing oxidative stress, neuroinflammation, excitatory amino acid toxicity, and blood-brain barrier damage. Though intravenous thrombolysis and endovascular therapy have dramatically improved the prognosis of patients with AIS, the narrow therapeutic window and ischemia-reperfusion injury still limit the benefits for a considerable proportion of patients. Edaravone dexborneol is a compound neuroprotective agent, composed of edaravone and dexborneol in a 4∶1 ratio, exerting cerebral protection through a synchronized dual-target mechanism of antioxidation and anti-inflammation. In this review, the pharmacological mechanism, clinical research results (including clinical randomized controlled trial studies and real-world studies), combination treatment strategies, applications in special stroke subtypes, and future research directions of edaravone dexborneol are summarized. Furthermore, we explore the potential for individualized precision therapy to guide the rational clinical use of this agent.

1
国家卫生健康委加强脑卒中防治工作减少百万新发残疾工程专家委员会, 吉训明. 《2024年中国脑卒中防治报告》概要[J]. 首都医科大学学报, 2025, 46(6): 947-960.
2
Jiang Y, Wang G, Jiang S, et al. Molecular mechanisms and targeted intervention strategies of calcium overload in ischemic stroke[J]. Int J Mol Sci, 2026, 27(5): 2279.
3
中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性卒中诊治指南2023[J]. 中华神经科杂志, 2024, 57(6): 523-559.
4
霍晓川, 高峰. 急性缺血性卒中血管内治疗中国指南2023[J]. 中国卒中杂志, 2023, 18(6): 684-711.
5
Deng G, Chu YH, Xiao J, et al. Risk factors, pathophysiologic mechanisms, and potential treatment strategies of futile recanalization after endovascular therapy in acute ischemic stroke[J]. Aging Dis, 2023, 14(6): 2096-2112.
6
Pereira da Silva AM, Ribeiro Gonçalves O, Falcão L, et al. Association between the no-reflow phenomenon and clinical outcomes after endovascular treatment for acute ischemic stroke: a systematic review and Meta-analysis[J]. Eur Stroke J, 2026, 11(1): 23969873251376846.
7
Xu L, Gao Y, Hu M, et al. Edaravone dexborneol protects cerebral ischemia reperfusion injury through activating Nrf2/HO-1 signaling pathway in mice[J]. Fundam Clin Pharmacol, 2022, 36(5): 790-800.
8
Xu J, Wang A, Meng X, et al. Edaravone dexborneol versus edaravone alone for the treatment of acute ischemic stroke: a phase Ⅲ, randomized, double-blind, comparative trial[J]. Stroke, 2021, 52(3): 772-780.
9
冯洁, 刘泽宇, 樊屹殊. 缺血性卒中脑细胞保护临床实践中国专家共识[J]. 国际神经病学神经外科学杂志, 2025, 52(2): 1-7.
10
Yamashita T, Abe K. Update on antioxidant therapy with edaravone: expanding applications in neurodegenerative diseases[J]. Int J Mol Sci, 2024, 25(5): 2945.
11
周文, 赵秀丽. 依达拉奉右莰醇在缺血性脑卒中的研究进展[J]. 临床医学进展, 2023, 13(6): 9947-9951.
12
符元号, 张晓娜, 谢忱忱. 依达拉奉在经颅内血肿微创引流术后硬膜外血肿患者中的应用[J]. 药学进展, 2025, 49(8): 698-702.
13
Chen Z, Li T, Tang HB, et al. Edaravone dexborneol provides neuroprotective effect by inhibiting neurotoxic activation of astrocytes through inhibiting NF-κB signaling in cortical ischemia[J]. Brain Res Bull, 2024, 218: 111097.
14
Hu R, Liang J, Ding L, et al. Edaravone dexborneol provides neuroprotective benefits by suppressing NLRP3 inflammasome-induced microglial pyroptosis in experimental ischemic stroke[J]. Int Immunopharmacol, 2022, 113(Pt A): 109315.
15
Rahmati-Dehkordi F, Khanifar H, Zare-Hoseinabadi A, et al. Potential of edaravone dexborneol in the treatment of cerebral ischemia: focus on cell death-related signaling pathways[J]. Mol Biol Rep, 2024, 51(1): 1007.
16
Zhang H, Cao R, Chen W, et al. Abstract WP21: the novel target and mechanism of clinically used edaravone dexborneol for ischemic stroke in China[J]. Stroke, 2025, 56(Suppl_1): AWP21-AWP21.
17
杨晨昕, 李伟. 炎症指标在脑卒中诊疗中的关键作用及研究新进展[J]. 临床个性化医学, 2025, 4(3): 585-598.
18
Wang X, Liu JJ, Zheng XR, et al. (+)-Borneol enhances the protective effect of edaravone against cerebral ischemia/reperfusion injury by targeting OAT3/P-gp transporters for drug delivery into the brain[J]. Phytomedicine, 2025, 139: 156521.
19
Prabhakaran S, Gonzalez NR, Zachrison KS, et al. 2026 guideline for the early management of patients with acute ischemic stroke: a guideline from the American Heart Association/American Stroke Association[J/OL]. Stroke, 2026-01-26 (2026-07-01).
20
Wu HY, Tang Y, Gao LY, et al. The synergetic effect of edaravone and borneol in the rat model of ischemic stroke[J]. Eur J Pharmacol, 2014, 740: 522-531.
21
Xu J, Wang Y, Wang A, et al. Safety and efficacy of edaravone dexborneol versus edaravone for patients with acute ischaemic stroke: a phase Ⅱ, multicentre, randomised, double-blind, multiple-dose, active-controlled clinical trial[J]. Stroke Vasc Neurol, 2019, 4(3): 109-114.
22
Fu Y, Wang A, Tang R, et al. Sublingual edaravone dexborneol for the treatment of acute ischemic stroke: the TASTE-SL randomized clinical trial[J]. JAMA Neurol, 2024, 81(4): 319-326.
23
Ma G, Mo R, Yao X, et al. Clinical and safety outcomes of edaravone dexborneol in acute ischemic stroke: a multicenter, prospective, cohort study[J]. Neurology, 2025, 105(4): e213949.
24
吴伟杰, 孙紫徽, 徐良额, 等. 依达拉奉右莰醇联合阿替普酶治疗急性缺血性脑卒中疗效的随机对照试验[J]. 药物流行病学杂志, 2024, 33(9): 978-985.
25
Chen HS, Zhao ZA, Shen XY, et al. Edaravone dexborneol for ischemic stroke with sufficient recanalization after thrombectomy: a randomized phase Ⅱ trial[J]. Nat Commun, 2025, 16(1): 2393.
26
Wang C, Gu H, Huo X, et al. Edaravone dexborneol versus placebo on functional outcomes in patients with acute ischaemic stroke undergoing endovascular thrombectomy (TASTE-2): randomised controlled trial[J]. BMJ, 2026, 392: e086850.
27
李一才, 韩国胜, 窦寿坦, 等. 依达拉奉右莰醇联合丁苯酞注射液治疗急性进展性脑梗死患者的临床研究[J]. 中国临床药理学杂志, 2023, 39(6): 763-767.
28
张红梅, 陈燕. 银杏叶提取物注射液联合依达拉奉右莰醇治疗急性脑梗死的效果及对患者神经功能的影响[J]. 临床医学, 2024, 44(1): 117-120.
29
Wang A, Jia B, Zhang X, et al. Efficacy and safety of butylphthalide in patients with acute ischemic stroke: a randomized clinical trial[J]. JAMA Neurol, 2023, 80(8): 851-859.
30
Dávalos A, Alvarez-Sabín J, Castillo J, et al. Citicoline in the treatment of acute ischaemic stroke: an international, randomised, multicentre, placebo-controlled study (ICTUS trial)[J]. Lancet, 2012, 380(9839): 349-357.
31
刘旭, 拜承萍. 急性缺血性脑卒中侧支循环影响因素的研究进展[J]. 临床医学进展, 2022, 12(10): 9576-9581.
32
杨丽娟, 武佳芳. 椎动脉发育不良与急性后循环缺血性脑卒中[J]. 中华老年心脑血管病杂志, 2018, 20(1):75-77.
33
Meng S, Tan Q, Guo J, et al. Beyond anterior circulation: clinical outcomes of edaravone dexborneol in posterior circulation stroke[J]. J Stroke Cerebrovasc Dis, 2026, 35(9): 108703.
34
Ma G, Raynald, Arham A, et al. Edaravone dexborneol in large ischemic stroke: real-world experience from a multicenter study in China[J]. J Am Heart Assoc, 2026, 15(1): e044296.
35
克地尔牙·马合木提, 胡波, 杨琼, 等. 依达拉奉右莰醇对急性脑梗死后认知功能障碍的疗效观察[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(5): 459-466.
[1] 傅书强, 王宏刚. 液体活检主要生物标志物在结直肠癌中的研究进展[J/OL]. 中华结直肠疾病电子杂志, 2026, 15(03): 274-281.
[2] 王兆彤, 陈磊, 王莹莹, 王国栋, 苑小历. 面部情绪识别缺陷在抑郁症患者自杀风险评估中的作用:机制及临床应用[J/OL]. 中华临床医师杂志(电子版), 2026, 20(03): 234-238.
[3] 李晓慧, 杭宇, 汪璇, 贾振宇, 茆丽娜, 代龙泉, 施海彬, 季荔. 阿替普酶静脉溶栓桥接机械取栓治疗急性前循环大血管闭塞性脑卒中后出血转化的危险因素分析[J/OL]. 中华介入放射学电子杂志, 2026, 14(03): 286-291.
[4] 欧国敏, 欧启水. 慢性乙型肝炎实验室标志物:循证依据、临床应用及管理策略[J/OL]. 中华临床实验室管理电子杂志, 2026, 14(02): 157-165.
[5] 李若曼, 王帆, 张涛. ASPECTS联合表观弥散系数对急性缺血性脑卒中静脉溶栓预后的预测价值[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(04): 403-410.
[6] 张爽, 谢琦, 杨清武. 急性缺血性脑卒中无效再通的研究进展及脑保护新策略[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(04): 351-358.
[7] 戴荣源, 裴月红, 孙庆利, 黄骁, 张淦, 樊东升, 傅瑜. 美国心脏协会/美国卒中协会《2026年急性缺血性脑卒中患者早期管理指南》更新概述[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(04): 359-364.
[8] 曾陈颖, 陈云清, 徐祖兵, 余求龙, 林晶, 洪道俊, 涂琪. 炎症标志物在大梗死核心与非大梗死核心急性缺血性脑卒中行血管内治疗的预后价值[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(04): 372-379.
[9] 魏宸铭, 牟婧宇, 赵心怡, 陈乐, 武剑. 不同评分量表对前循环大血管闭塞性脑卒中诊断预测性能的差异[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(04): 380-388.
[10] 康志霞, 班玉霞, 白如玉, 郝美美, 李正正, 苏琴琴. 血浆致动脉硬化指数和程序性细胞死亡因子4预测急性缺血性脑卒中神经功能缺损及预后的价值[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(04): 389-395.
[11] 胡琼丹, 侯善兵, 陈霞, 王教媛, 戴晓熹. 应激性血糖升高比值预测急性缺血性脑卒中静脉溶栓预后的价值[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(04): 396-402.
[12] 周英, 李文雯, 周钰, 李炜, 贺思怡, 夏海艳, 王海玲. 基于临床医护人员视角的急性缺血性脑卒中患者就医延迟成因与对策的质性研究[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(04): 446-454.
[13] 吴嶛, 蔡诗昆, 左鹏, 倪贵华, 倪小宇. 急性缺血性脑卒中机械取栓前血栓迁移与临床资料的相关性[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(03): 287-293.
[14] 柳云鹏, 贾建文, 黄菊梅, 汪阳. 早期血压变异性对大血管闭塞性急性缺血性脑卒中术后神经功能恢复的影响[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(03): 274-279.
[15] 单子恒, 王帆, 马丽, 张涛, 邵丽. 头颈部CT血管成像联合头颅CT灌注成像评估急性缺血性脑卒中患者短期预后的效能[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(02): 164-169.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?