抗血小板治疗策略对于经皮冠状动脉介入术预后影响的研究现状

Research status of the effect of antiplatelet therapy strategies on the prognosis of percutaneous coronary intervention

冠心病(CHD)是严重危害人类健康的全球性疾病,发病率、死亡率不断上升,已成为人类社会严重的慢性病之一,尤其是急性冠状动脉综合症(ACS)。经皮冠状动脉介入术(PCI)是治疗ACS的主要方法。然而PCI可能会引起血管壁的损伤和炎症反应,进而引起心肌损伤。本文综述了抗血小板药物对PCI预后的影响。替格瑞洛和普拉格雷作为强效P2Y12强效抑制药,与氯吡格雷相比,可以显著减少心源性死亡、心肌梗死、再次血运重建、支架血栓形成、支架内狭窄等事件的发生,但是同时也导致出血风险的增加。除药物种类的因素外,许多研究证明降低剂量或缩短双联抗血小板治疗时长可以减少出血事件且不增加缺血事件。

Coronary heart disease(CHD)is a global disease that harms human health seriously.The incidence and mortality of CHD are rising,and it has the most become one of serious chronic diseases in human society,especially acute coronary syndromes(ACS).Percutaneous coronary intervention(PCI)is the main method for the treatment of ACS.However,PCI may cause damage to the vascular wall and inflammatory response,thus causing myocardial injury.We reviewed the influence of antiplatelet drugs on the prognosis of PCI.Compared with clopidogrel,ticagrelor and prasugrel can significantly reduce the occurrence of events such as cardiac death,myocardial infarction,revascularization,stent thrombosis,and intrastent stenosis.But ticagrelor and prasugrel are associated with higher risk of bleeding.