抗血小板药物研究进展

Research progress on antiplatelet drugs

目前,急性冠脉综合征标准治疗方案是应用双联抗血小板药物基础上联合抗凝药物,即阿司匹林联合血小板二磷酸腺苷(ADP)受体P2Y12阻滞剂联合肝素类或戊糖类药物,对于一些高危患者还需适当加用血小板膜糖蛋白(GP)Ⅱb/Ⅲa受体拮抗剂。缺血性疾病的二级预防也要求使用一定时期的双联抗血小板药物治疗,之后终生服用合适剂量的阿司匹林或氯吡格雷。然而,抗血小板药物的应用是一把"双刃剑",在发挥治疗作用的同时也存在很大的潜在出血风险,如脑卒中及严重内脏出血等,因此,选择应用抗血小板药物时,应权衡利弊、综合分析,在争取获得最优治疗效果的同时,最大限度减少出血等不良反应的发生。

Current standard therapy for acute coronary syndrome is dual antiplatelet therapy, combining aspirin with an inhibitor of ADP platelet receptor P2Y12, together with anticoagulants, heparin or anticoagulation pentose, and for some high-risk patients, platelet membrane glycoprotein （GP） Ⅱb/Ⅲa antagonists, if needed.Also, the secondary prevention of ischemic events requires a certain period of dual antiplatelet therapy, followed by life-long suitable dose of aspirin or clopidogrel.However, antiplatelet drug, a double-edged sword, its improved antiplatelet efficacy is offset by an increased risk of bleeding, such as stroke, severe visceral bleeding, and so on.Therefore, when selecting the anti-platelet drugs, clinicians should weigh the pros and cons and make comprehensive analysis, so as to obtain the best therapeutic effect and minimize the bleeding and other adverse reactions at the same time.