抗血小板治疗出凝血平衡研究进展

Progress in bleeding and coagulation balance during antiplatelet therapy

血小板参与正常的止血功能,也是病理性血栓形成的关键因素。抗血小板药物针对活化血小板表面丰富的受体,按不同的作用靶点抑制血小板的激活而发挥抗栓作用。但抑制血小板的作用越强,伴随的出血风险越高。新型的P2Y12受体拮抗剂从前体药物转为直接活性药物,起效更快,作用更强,抑制血小板聚集从不可逆转为可逆,一旦停药,可以迅速恢复血小板的生理功能,而且由于其"治疗窗"较宽,出凝血平衡易于控制,更能保障疗效与用药安全,达到抗血小板治疗的最佳目标。

Platelets involve in normal homeostatic function. It is a key element of pathological thrombosis. Antiplatelet agents activate the receptors on platelet surface and play an antithrombotic role in inhibiting platelet activation according to different targets. However,the greater inhibition of platelet functions,the higher risk of bleeding. New inhibitors of P2Y12 receptor act directly from prodrug to active drug and achieve more rapid and greater platelet inhibition. In addition,the inhibition of platelet aggregation is reversible. Once we stop the drug use,the physiological functions of platelets can quickly restore.Since it has a＂wide therapeutic window＂,it is easy to control the balance between bleeding and coagulation,to ensure safety usage and curative effect,and to achieve the desired goal of antiplatelet therapy.