急性冠状动脉综合征合并心源性休克患者应用P2Y_(12)受体拮抗剂研究进展

Research Progress of P2Y_(12) Receptor Antagonist for Patients with Acute Coronary Syndrome Complicating Cardiogenic Shock

急性冠状动脉综合征(ACS)是一种心脏急性缺血性综合征,而心源性休克(CS)是急性心肌梗死后泵衰竭的严重并发症。ACS合并CS患者常伴肝功能不全等多器官功能损害,影响药物的活化代谢,亦是ACS患者临床死亡的主要原因。血小板的黏附、活化和聚集是ACS患者血栓形成的重要因素。目前,P2Y_(12)受体抑制剂是ACS患者抗血小板治疗的常用药物,但部分患者用药后而表现为血小板高反应性,亦增加临床心血管不良事件。

Acute coronary syndrome （ACS） is a heart acute ischemic syndrome,and cardiogenic shock（CS） is a seri- ous complication of pump failure after acute myocardial infarction, and patients of ACS complicated with CS are often accom- partied by liver dysfunction and other multiple functional organ impairment, which will affect the activation and metabolism of drugs,and is the main cause of clinical death of ACS patients. Platelet adhesion,ctivation and aggregation are important factors in thrombosis in ACS patients. At present, P2Y12 receptor inhibitors are commonly used drugs as anti-platclet therapy for ACS patients, but some patients show platelet hyperrespousiveness after application of the drug, with increased cardiovas- cular adverse events in clinical.