卒中是全球疾病、损伤和风险因素负担研究中的一大疾病，其中缺血性卒中（acute ischemic stroke， AIS）占比约75%。静脉溶栓作为AIS最为有效的治疗手段之一，可在发病后第一时间开通闭塞血管、恢复 血流，最大程度地降低AIS患者残疾或死亡的风险。近年来，众多具有较高安全性与独特疗效的静脉溶栓 新型药物备受瞩目。本文将对尿激酶原、瑞替普酶、替奈普酶这3种用于静脉溶栓治疗的药物，从多中心研 究现状、潜在作用机制等方面展开系统性总结，旨在为后续临床研究的推进，以及更多潜在机制的深入探 索，提供坚实的理论支撑。

Stroke ranks among the leading causes of global disease burden, injury, and risk factors, with acute ischemic stroke (AIS) accounting for approximately 75% of cases. Intravenous thrombolysis stands as one of the most effective treatments for AIS, enabling rapid recanalization of occluded vessels and restoration of blood flow to minimize disability or mortality risks in patients. In recent years, novel intravenous thrombolytic agents with favorable safety profiles and distinct therapeutic benefits have gained significant attention. This review systematically summarizes evidence from multicenter studies and explores potential mechanisms underlying three such drugs—prourokinase, reteplase, and tenecteplase—aiming to provide theoretical support for advancing clinical research and deepening insights into their mechanisms of action.