2026美国心脏学会/美国卒中学会急性缺血性卒中患者早期管理指南静脉溶栓要点与解读Interpretation of the Key Updates on Intravenous Thrombolysis in the 2026 Guideline for the Early Management of Patients with Acute Ischemic Stroke: A Guideline from the American Heart Association/American Stroke Association

2026美国心脏学会/美国卒中学会急性缺血性卒中患者早期管理指南于2026年1月发布，其在静脉溶栓方面的推荐有大量更新，内容涵盖药物选择、儿童患者筛选、时间窗延长、禁忌证减少，以及轻型非致残性卒中不建议静脉溶栓等。本文对2026版指南静脉溶栓方面的更新要点进行总结和解读，以期为国内急性缺血性卒中静脉溶栓临床实践提供参考。The ‌2026 Guideline for the Early Management of Patients with Acute Ischemic Stroke: A Guideline from the American Heart Association/American Stroke Association was released in January 2026. It contains substantial updates to the recommendations on intravenous thrombolysis, covering agent selection, screening of pediatric patients, extended therapeutic time windows, reduced contraindications, and that intravenous thrombolysis is not recommended for mild non-disabling stroke. This article summarizes and interprets these key updates, aiming to provide a reference for the clinical practice of intravenous thrombolysis among patients with acute ischemic stroke in China.