Mustard J F, Packham M A
Drugs. 1975;9(1):19-76. doi: 10.2165/00003495-197509010-00003.
The development of thrombosis involves 4 main factors: the vessel wall, the formed elements of the blood, blood coagulation, and blood flow. In venous thrombosis, however, the major part in both the initiation and growth of thrombi is played by the platelets. In selecting drugs which inhibit platelet function it is helful to know which of the platelet reactions that contribute to thrombus formation can be inhibited by various agents. Platelets adhere to the damaged vessel wall, collagen being probably the most important constituent involved. They are then stimulated to release the contents of their storage granules. Release-inducing agents promote the discharge of adenosine diphosphate (ADP) which causes platelets in the vicinity to swell to a more spherical shape, extend pseudopods and adhere to each other. Platelet aggregation is reversible, and a number of drugs have been shown to be capable of inhibiting platelet function at various stages, both in vitro and in vivo. Adrenaline, noradrenaline, oestrogens and nicotine enhance aggregation. Drugs which inhibit platelet function include the non-steroidal anti-inflammatory drugs, the pyrimido-pyrimidines (e.g. dipyridamole), hydroxychloroquine, clofibrate, and dextran. In this review the effects of drugs which inhibit platelet function are outlined and the extent to which they can be used to influence the course of thromboembolic disease in man is discussed. It is suggested that combination of anti-platelet drugs with anticoagulants could prove clinically useful.
血栓形成的发展涉及4个主要因素：血管壁、血液中的有形成分、血液凝固和血流。然而，在静脉血栓形成中，血栓形成和生长的主要作用由血小板发挥。在选择抑制血小板功能的药物时，了解各种药物能抑制哪些导致血栓形成的血小板反应是有帮助的。血小板黏附于受损的血管壁，胶原蛋白可能是其中最重要的参与成分。然后它们受到刺激，释放储存颗粒的内容物。释放诱导剂促进二磷酸腺苷（ADP）的释放，ADP会使附近的血小板肿胀成更球形的形状，伸出伪足并相互黏附。血小板聚集是可逆的，并且已经证明许多药物在体外和体内的各个阶段都能够抑制血小板功能。肾上腺素、去甲肾上腺素、雌激素和尼古丁会增强聚集。抑制血小板功能的药物包括非甾体抗炎药、嘧啶并嘧啶类（如双嘧达莫）、羟氯喹、氯贝丁酯和右旋糖酐。在这篇综述中，概述了抑制血小板功能的药物的作用，并讨论了它们在多大程度上可用于影响人类血栓栓塞性疾病的病程。有人提出抗血小板药物与抗凝剂联合使用可能在临床上有用。
