冠心病介入治疗患者个体化抗血小板治疗进展

Treatment progress of interventional therapy individualized antiplatelet on coronary heart disease patients

冠心病已成为威胁我国人民身体健康的重大心血管疾病之一。经皮冠状动脉支架植入术是治疗严重冠心病的重要方法,为了减少术后支架内血栓事件的发生率,术后服用双联抗血小板药物得到了各国指南推介。氯吡格雷是最常用的双联抗血小板药物之一,但研究显示,部分患者服用氯吡格雷后,仍有较高的支架内血栓发生率,即存在血小板抵抗(high on-treatment platelet reactivity,HTPR)。对于这部分患者,增加氯吡格雷剂量或改换药物能否改善HTPR,目前研究结果仍有争议。本文从HTPR的筛查方法、新型抗血小板药物的应用以及预后等方面对该问题进行综述。

Coronary heart disease has been become one of the major cardiovascular disease, which threat to people＇s health in our country, percutaneous coronary artery stent implantation is an important method for the treatment of severe coronary heart disease, the postoperative double antiplatelet drugs are the national guidelines, in order to reduce the stent thrombosis events incidence, clopidogrel is one of the most commonly used dual antiplatelet drugs, while the study showed that there were still a high stent thrombosis incidence after taken clopidogrel in some patients. The platelet resistance（high on-treatment platelet reactivity, HTPR） was the factor, for this part of the patients, the results of whether the increase of clopidogrel dose or the change of drugs can improve the HTPR is still controversial at present, in this article, we reviewed the HTPR screening method, the application of new anti platelet drugs and the prognosis of the patients,