经皮冠状动脉介入治疗患者血小板高反应性的精准评估与临床策略浅析  

Accurate Assessment and Clinical Strategic Decision Making of Patients with High Platelet Reactivity Undergoing Percutaneous Coronary Intervention

作　　者：李京秀[1] 宋兆炎 闫述钧[1] 孙驰 李学奇[1] 韩百合 李阳[1] 夏德军 李馨[1] 金恩泽[1] LI Jingxiu SONG Zhaoyan YAN Shujun SUN Chi LI Xueqi HAN Baihe LI Yang XIA Dejun LI Xin JIN Enze.(Department of Cardiology, the Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001, China)

机构地区：[1]哈尔滨医科大学附属第四医院心血管内科,哈尔滨150001

出　　处：《医学综述》2017年第18期3604-3609,3614,共7页Medical Recapitulate

基　　金：黑龙江省留学归国科学基金(LC2011C10);哈尔滨医科大学第四临床医学院首届杰出青年基金(HYDSYJQ201504)

摘　　要：血小板的黏附、活化、聚集在急性冠状动脉综合征及经皮冠状动脉介入(PCI)治疗的病理生理进程中占主导地位。阿司匹林和血小板腺苷二磷酸P2Y12受体抑制剂(氯吡格雷、替格瑞洛等)是临床应用的经典抗血小板药物,同时也是急性冠状动脉综合征与PCI的基石。随着对抗血小板领域研究的不断拓展,个体对抗血小板药物治疗存在明显的反应性差异,这种差异与冠状动脉支架术后复合终点事件显著相关。因此,精准评估PCI患者在接受抗血小板药物治疗后血小板反应性的情况,给予规范化、个体化的临床治疗方案以减少死亡、非致死性心肌梗死、血栓事件及出血事件的发生,对改善患者远期预后具有深远的临床意义。Platelet adhesion, activation and aggregation play a key role in the pathophysiology of the treatment of acute coronary syndromes and percutaneous coronary intervention（PCI）. Aspirin and platelet adenosine diphosphate P2Y12 recep- tor inhibitors （clopidogrel,ticagrelor, etc. ） are classic antiplatelet drugs for clinical use, and also the cornerstone of acute coronary syndromes and PCI. With the continuous expansion of the field of platelet research, there is a significant difference in individual response to platelet drug therapy, which is significantly related to the composite end point after coronary stent implantation. Therefore, accurate evaluation of platelet reactivity in patients with PCI receiving antiplatelet drugs after treat- ment, giving standardized and individualized clinical treatment in order to reduce the occurrence of death, nonfatal myocar- dialinfarction,thromboembolic events and bleeding events,has profound clinical significance to improve the prognosis of the patients.

关 键 词：氯吡格雷 血小板高反应性 血小板腺苷二磷酸P2Y12受体抑制剂 

分 类 号：R541.4[医药卫生—心血管疾病]