Samama M M
Service d'hématologie biologique Hôtel-Dieu, Paris.
Rev Prat. 1999 Oct 1;49(15):1664-8.
Thrombosis is the most frequent cause of venous and arterial vascular events. Anticoagulants and antiplatelet agents are able to prevent both types of thrombotic episodes. However, available agents have limitations which justify the search for new antithrombotic drugs or at least the clinical investigation of combined treatment with already available drugs. Progress in the knowledge of the mechanism of thrombosis guides the search for new antithrombotic agents. Novel strategies should take into account the intensity of the thrombogenic stimulus involved in the occurrence of the thrombotic episodes. Among antiplatelet agents, the logic combination of aspirin and ticlopidine or clopidogrel is already challenging the anti-GP IIb/IIIa orally active compounds. Among anticoagulant agents a long list of competitors for the replacement of oral anticoagulants and heparins is already available. They target factors Xa, IIa or VIIa. A promising alternative is to increase the thromboresistance of the vascular wall.
血栓形成是静脉和动脉血管事件最常见的原因。抗凝剂和抗血小板药物能够预防这两种类型的血栓形成事件。然而，现有药物存在局限性，这使得人们有理由寻找新的抗血栓药物，或者至少对现有药物的联合治疗进行临床研究。血栓形成机制知识的进展指导着新抗血栓药物的研发。新策略应考虑到血栓形成事件发生时血栓形成刺激的强度。在抗血小板药物中，阿司匹林与噻氯匹定或氯吡格雷的合理联合已经对口服活性抗GP IIb/IIIa化合物构成挑战。在抗凝剂中，已有一长串有望替代口服抗凝剂和肝素的药物。它们作用于因子Xa、IIa或VIIa。一个有前景的替代方法是增强血管壁的抗血栓能力。
