Behan M W H, Storey R F
Division of Cardiovascular Medicine, University Hospital, Derby Road, Nottingham NG7 2UH, UK.
Postgrad Med J. 2004 Mar;80(941):155-64. doi: 10.1136/pgmj.2003.007062.
Platelet activation and aggregation are considered to be central to arterial thrombus formation. Antiplatelet therapy is therefore important for both the treatment and prevention of cardiovascular disease. Aspirin, the most widely used antiplatelet agent, inhibits platelet cyclo-oxygenase and the conversion of arachidonic acid to the potent platelet agonist thromboxane A(2) but does not prevent platelet activation occurring via various signalling pathways that are independent of thromboxane A(2) release. Therefore a number of other compounds have been developed to complement aspirin's beneficial effect. These include the thienopyridines (clopidogrel and ticlopidine), dipyridamole, and the alpha(IIb)beta(3) (glycoprotein IIb/IIIa) receptor inhibitors.
血小板活化和聚集被认为是动脉血栓形成的核心环节。因此,抗血小板治疗对于心血管疾病的治疗和预防都非常重要。阿司匹林是使用最广泛的抗血小板药物,它抑制血小板环氧化酶以及花生四烯酸向强效血小板激动剂血栓素A2的转化,但不能阻止通过与血栓素A2释放无关的各种信号通路发生的血小板活化。因此,已开发出许多其他化合物来补充阿司匹林的有益作用。这些包括噻吩并吡啶类(氯吡格雷和噻氯匹定)、双嘧达莫以及α(IIb)β(3)(糖蛋白IIb/IIIa)受体抑制剂。