以西洛他唑为基础的三联抗血小板在冠状动脉支架植入术中的研究进展

Progress in triple antiplatelet therapy on the basis of cilostazol after coronary artery stent implantation

经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）已经成为冠状动脉粥样硬化性心脏病的重要手段之一。术后常规的抗血小板治疗尤为重要，阿司匹林联合腺苷二磷酸受体拮抗剂氯吡格雷的双联抗血小板治疗（dual antiplatelet therapy，DAPT）已被广泛应用于接受冠状动脉支架手术的患者中。但即使接受标准的抗血小板治疗，仍有1％～4％患者发生支架内血栓事件，其死亡率高达40％以上。而西洛他唑是新型的活性多样的抗血小板药物，可针对术后的多种危险因素进行干预，对 PCI 的患者可降低心血管事件和支架内再狭窄（restenosis，RS）的发生。以西洛他唑联合阿司匹林、氯吡格雷的三联抗血小板治疗（triple antiplatelet therapy，TAPT）已被日、韩及我国的很多心脏中心应用于 PCI 术后抗血小板治疗。为帮助医生在临床应用中更合理的使用西洛他唑，笔者综述 TAPT 在 PCI 术后患者中的研究进展。

Abstarct：Percutaneous Coronary intervention has become one of the important treatment for coronary atherosclerotic heart.Conventional antiplatelet therapy after surgery is particularly important.Dual Antiplatelet Therapy of aspirin combined adenosine diphosphate receptor antagonist clopidogrel has been widely used in the patients after coronary artery stent implantation by global cardiology doctors,many clinical studies have confirmed its effect inreducing adverse cardiac events.But even if accepting the standardized antiplatelet therapy, there is still 1% to 4% of patients occuring stent thrombosis,its mortality rate is as high as 40% above.However,cilostazol is the new variety of active antiplatelet drugs,it can intervene many kinds of risk factors for postoperation and reduce cardiovascular events and the incidence of Restenosis.Cilostazol combined aspirin and clopidogrel of Triple Antiplatelet Therapy has been applied to after PCI in Ja-pan,Korea and many of the China Heart Center.In order to help the doctor use Cilostazol more reasonablely in the clinical application, This acticle reviews progress in TAPT research for patient after PCI.