心肌梗死合并脑梗死的抗血小板药物治疗

Antiplatelet agent therapy for myocardial infarction complicated with cerebral infarction

心肌梗死和脑梗死是目前严重危害人类健康的血管性疾病,由其引起的死亡率占到所有死因的第一位。动脉粥样硬化病变基础上血栓形成是心脑血管疾病（冠状动脉疾病和脑血管病）多种进行性表现的常见基础过程。抗血小板治疗是动脉粥样硬化患者药物治疗的基石。过去20年来,抗血小板药物治疗在冠状动脉疾病上取得重大进展。但在治疗过程中由于脑血管病患者发生缺血和出血的风险增加,因此用于冠状动脉疾病和脑血管病患者抗血小板治疗药物组合的风险和益处是不确定和复杂的。本文提供了目前关于抗血小板治疗最前沿的证据,抗血小板药物用于二级预防冠状动脉疾病和脑血管病在动脉粥样硬化病变基础上血栓形成事件的进展。

Myocardial infarction and cerebral infarction are the vascular diseases that are currently and seriously endangering human health,and the mortality rate is the first cause of death. The development of thrombosis after atherosclerotic lesions is a common underlying process for a variety of progressive manifestations caused by cardiovascular and cerebrovascular diseases（ coronary artery disease and cerebrovascular disease）. For the drug treatment to patients with atherosclerosis,the antiplatelet therapy is deemed as the cornerstone. In the past two decades,significant progress has been achieved in antiplatelet drug therapy,especially for coronary artery disease patients. However,it is difficult to definitely determine the risks and benefits of antiplatelet drug combinations for coronary artery disease and cerebrovascular disease patients,since the risk of ischemia and hemorrhage incurred in patients with coronary artery disease is to be increased during the treatment. This article provides the current evidence for the forefront of antiplatelet therapy,and the progress of antiplatelet drugs for thrombosis events in two stage prevention of coronary artery disease and cerebrovascular disease on the basis of atherosclerotic lesions.