高危非致残缺血性脑血管事件抗血小板治疗的研究进展

Research progress of antiplatelet therapy for high-risk non-disabling ischemic cerebrovascular events

高危非致残缺血性脑血管事件早期卒中复发风险高,抗血小板治疗是其治疗的基石。短期双联抗血小板治疗可减少90 d的卒中复发风险,但仍有部分患者抗血小板治疗效果不佳,其中抗血小板药物抵抗是导致抗血小板治疗疗效降低的重要原因之一。对于氯吡格雷抵抗的患者而言,替换为替格瑞洛进行双联抗血小板治疗是很好的选择。目前双联抗血小板治疗效果仍不够理想,联合强化降脂治疗、抗炎治疗等或许能有更多获益。

High-risk non-disabling ischemic cerebrovascular events have a high risk of early stroke recurrence.Antiplatelet therapy is the cornerstone of the treatment.Short-term dual antiplatelet therapy can reduce the risk of stroke recurrence at 90 d,but there are still some patients with poor response to antiplatelet therapy,and antiplatelet drug resistance is one of the important reasons leading to reduced platelet efficacy.In patients with clopidogrel resistance,dual antiplatelet therapy with ticagrelor replacement is a good option.At present,the effect of dual antiplatelet therapy is still not ideal,and the combination of intensive lipid-lowering therapy and anti-inflammatory therapy may have more benefits.