血小板反应性对PCI术后远期心血管不良结局影响的研究进展

Research progress on the impact of platelet reactivity on long-term adverse cardiovascular outcomes after PCI

经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)是高危冠状动脉疾病患者的主要血管重建策略,降低PCI围手术期缺血、血栓形成等并发症对改善预后至关重要,而血小板的活化、聚集及抑制不足引起的高血小板反应性(high platelet reactivity,HPR)在PCI治疗后的血栓形成中起着关键作用。研究表明,HPR不仅是PCI术后发生心肌梗死、支架内血栓形成等主要不良心血管事件(major adverse cardiovascular events,MACE)的预测因子,也和围手术期抗血小板药物疗效降低相关。本文综述HPR在血小板血栓形成中的相关机制、HPR对PCI术后MACE的预测价值及抗血小板治疗的临床指导价值。

Percutaneous coronary intervention(PCI) is the main vascular reconstruction strategy for the patients with high-risk coronary artery disease.Reducing perioperative complications such as ischemia and thrombosis is very important to improve the prognosis.Platelet activation,aggregation and high platelet reactivity(HPR) caused by insufficient inhibition play a key role in the thrombosis after PCI.Studies have shown that HPR is not only a predictor of major adverse cardiovascular events(MACE) such as myocardial infarction and in-stent thrombosis after PCI,but also associated with reduced efficacy of perioperative antiplatelet drugs.This paper intends to explore the related mechanism of HPR in platelet thrombosis in order to evaluate the predictive value of HPR in MACE after PCI and the clinical guiding value of antiplatelet therapy.