缺血性卒中或短暂性脑缺血发作患者抗血小板药治疗期间血小板高反应性

High on-treatment platelet reactivity in patients with ischemic stroke or transient ischemic attack

抗血小板药是指南推荐的缺血性卒中/短暂性脑缺血发作(transient ischemic attack,TIA)长期治疗及二级预防的基石,用于降低复发性卒中及其他心血管事件风险。然而,某些缺血性卒中/TIA患者在抗血小板治疗期间仍会出现缺血性事件,称为治疗期间血小板高反应性(high on-treatment platelet reactivity,HTPR),通常发生在服用阿司匹林或氯吡格雷的患者中。文章阐述了缺血性卒中/TIA患者中HTPR的发生率、危险因素和常用评价方法,阐述HTPR在缺血性卒中/TIA患者中的临床意义,并探讨HTPR患者的抗血小板治疗方案。

Antiplatelet drugs are the cornerstone of long-term treatment and secondary prevention for ischemic stroke/transient ischemic attack(TIA)recommended by guidelines,aimed at reducing the risk of recurrent stroke and other cardiovascular events.However,some patients with ischemic stroke/TIA may still experience ischemic events during antiplatelet therapy,known as high on-treatment platelet reactivity(HTPR),which typically occurs in patients taking aspirin or clopidogrel.This article elaborates the incidence,risk factors,and commonly used evaluation methods of HTPR in patients with ischemic stroke/TIA,and elucidates the clinical significance of HTPR in patients with ischemic stroke/TIA,and investigates the antiplatelet treatment protocol of patients with HTPR.