急性冠状动脉综合征发病机制相关因素药物治疗的困惑和机遇

The perplexity and opportunity in the drug treatment of related factors of the pathogenesis mechanism of acute coronary syndrome

本文回顾急性冠状动脉综合征(ACS)发病机制相关因素药物治疗方面目前研究的现状,临床试验没有证实抗生素和降低血浆高同型半胱氨酸血症浓度以达到降低ACS发病率及死亡率的目的。氯吡格雷加阿司匹林强化的抗血小板治疗也未出现人们所希望的结果。TNT试验和IDEAL试验再次证实高胆固醇血症和ACS关系及LDL-C降的越低越好的理论。ExTRACT-TIMI 25试验和OASIS-5试验证实了一种较新的抗血栓药物在治疗ACS中的优势,它们为考虑更新和修改现行指南提供了重要的新证据。

In this article, the present status of the drug treatment of related factors of the pathogenesis mechanism of acute coronary syndrome （ACS） was reviewed. Clinical trail did not confirm that the antibiotics and lowering the concentration of blood plasma HCY might attain the purpose of decreasing the morbidity and mortality of ACS. The anti-platelets intensive treatment with Clopidogrel and aspirin did not bring a hopeful result to us. TNT and IDEAL trials demonstrated the correlation between high level of blood cholesterol and ACS and put forth the theory that the lower the level of blood LDL-c is, the better for the patients. Ex TRACT-TIMI25 and OASIS-5 trials confirmed the advantage of one anti-embolism drug to treat ACS. All of the above provide the evidence to renew and modify the guideline.