高危非致残性缺血性脑血管事件的个体化治疗

The Individualized Therapy for High Risk Non-Disabling Ischemic Cerebrovascular Events

分子标记物可使高危非致残性缺血性脑血管事件(high risk non-disabling ischemic cerebrovascular events,HR-NICE)患者的临床诊断、危险度分层、治疗方案和预后判断更加精确,但不同种族人群间存在卒中发生的原因以及基因位点的差异,从而使其对强化抗血小板治疗的获益也不尽相同。由于基因类型和蛋白存在与否的不同,患者对相同药物可能存在不同的收益,所以在决定诊疗方案时应充分考虑到这一差异,进行个体化治疗。新型抗凝和抗血小板药物无需代谢、直接起效,可能为未来的精准化治疗带来新的思路。

Molecular markers could help physicians make more accurate clinical diagnosis,risk stratification,treatment plan and prognosis evaluation for patients with high risk non-disabling ischemic cerebrovascular events（HR-NICE）.However,race/ethnic difference may influence the stroke etiology and gene locus,so that the effect of aggressive antiplatelet therapy is distinct with different varieties.Due to the different genotyping and protein,patients may gain different benefit from the drug therapy,so that individualized treatment should be adapted to the differences.New anticoagulants and antiplatelet agents can work directly,which may provide new direction for the future.