<International Circulation>: What was the primary objective and design of the SAMURAI rt-PA registry?

  《国际循环》： SAMURAI rt—PA注册研究的主要目的是什么？是如何设计的？
    Dr Kazunori Toyoda: SAMURAI was a retrospective multicentre observational study looking at low dose alteplase therapy at 0.6mg/kg for the treatment of stroke which has only been studied in Japan. Internationally 0.9mg/kg alteplase is used. 
 

    Kazunori教授：SAMURAI是一项实施的回顾性多中心观察研究，旨在观察仅在日本国内采用的低剂量阿替普酶（0.6mg/kg）治疗缺血性卒中的疗效，国际上常用剂量为0.9mg/kg。  

   <International Circulation>: There has been some concern that such a low dose was used. What are the advantages and disadvantages of using a lower dose compared to a higher one?

  《国际循环》：目前对如此低剂量疗法的应用存在诸多疑虑，那么与常规用量相比，低剂量疗法有哪些优势和不足？
    Dr Kazunori Toyoda: The advantage of small dose therapy is that there is a decrease in haemorrhagic complications in particular intracerebral haemorrhage. A possible disadvantage of using such a low dose may be incomplete recanalization. However， we have very recent data from a study also from Japan called the J-ACT 2 Trial and in that study using 0.6mg/kg dose of alteplase we can see 50% recanalization 6 hours after thrombosis. These trials highlight that a low dose is both feasible and effective at least for Japanese and possibly for Asian patients.

    Kazunori教授：低剂量药物治疗方案的优势是显著降低出血、特别是颅内出血的风险；不足之处是可能导致血管再通不完全。然而近期来自日本J-ACT 2试验的数据表明：在血栓形成后6 h内以0.6mg/kg 阿替普酶进行溶栓达到50%的血管再通率。这些试验结果说明低剂量阿替普酶溶栓方案用于日本患者或亚洲患者，是可行而且有效的。
    <International Circulation>: What are the clinical implications of the SAMURAI rt-PA registry?

  《国际循环》：SAMURAI rt-PA注册研究有何实际临床意义？
    Dr Kazunori Toyoda: There are some problems that need to be resolved such as enlarging the therapeutic time window. In Japan the 3 hour window is the rule but I think a 4.5 hour time window after onset of stroke is both safe and effective. There are new and promising devices such as the Penumbra System which are safe and effective and it would be interesting to see if combination therapy using such devices with alteplase therapy has any added benefits.

    Kazunori教授：我们还需要探讨很多问题，如溶栓治疗时间窗的延长。在日本，规定时间窗在3 h以内，但我认为卒中发作后的4.5 h作为时间窗仍然安全有效。此外，一些有前途的新型设备如Penumbra System已经问世，研究将这些新型设备与阿替普酶溶栓疗法联合应用是否会会带来额外获益将非常有意义。

Dr Kazunori Toyoda was the Principal Investigator for the SAMURAI Study.