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急性冠状动脉综合征新型抗血小板药物临床研究进展 被引量:2

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摘要 斑块破裂和血栓形成是导致冠状动脉粥样硬化病变急剧进展及发生心脏事件的重大病理改变,抗栓治疗尤其是抗血小板治疗自然成为急性冠脉综合征的重要干预环节。阿司匹林与早期的P2Y12受体拮抗剂(第一代噻氯吡啶ticlopidine、第二代氯吡格雷clopidogrel)长期占据抗血小板治疗优势地位,但药物上市后临床研究显示:二者存在多种缺陷及不足。譬如,阿司匹林抗血小板作用相对较弱;氯吡格雷虽然抗血小板疗效明显比阿司匹林增强,但其为非活性前体,需经肝微粒体酶CYP3A4/5及CYP2C19代谢为活性形式,因而氯吡格雷存在明显个体间疗效差异以及与其它药物相互作用而降低其疗效。氯吡格雷起效缓慢,即使大剂量负荷给药,需经2h后才能发挥明显血小板抑制作用,不能满足急诊介入治疗对血小板的即刻快速抑制要求。另外,对于不能进行介入治疗而需要外科干预的患者,氯吡格雷血小板抑制作用消失时间较长。鉴此,近年来一系列新的强效抗血小板制剂进入临床,现简介如下[1-3]。
出处 《中国介入心脏病学杂志》 2014年第2期125-127,共3页 Chinese Journal of Interventional Cardiology
基金 广东省自然科学基金(S2011010003867)
作者简介 通信作者:侯玉清,Email:drhouyuqing@126.com
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参考文献23

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