University of Perugia, Santa Maria della Misericordia Hospital, Sant'Andrea delle Fratte, Italy.
Expert Opin Pharmacother. 2009 Dec;10(18):2947-57. doi: 10.1517/14656560903386276.
Circulatory disease accounts for fifteen million deaths each year, of which stroke accounts for four and a half million- with an estimated nine million stroke survivors annually. The overall incidence rate of stroke is 2 to 2.5 per thousand adults with an approximate prevalence of 5 per thousand and an estimated 5-year risk of stroke recurrence of 15 to 40 percent. Conventional risk factors for stroke include: increasing age, hypertension, diabetes mellitus, smoking, increased body mass index, ischemic heart disease, heart failure, atrial fibrillation and lack of physical activity. Age is the strongest risk factor for both ischemic and haemorrhagic stroke with its incidence doubling for each successive decade after the age of fifty-five years. However, there is a substantial portion of patients with significant cerebrovascular disease who do not have any of these stroke risk-factors, leading to the speculation that there are other factors that have not been identified yet So as to improve diagnosis and treatment strategies, as well as to reduce the related public health burden, it could be helpful to successfully identify its extremely complex genetic determinants (polygenic, multiple genes play a role). Pharmacogenetics is the field of pharmacology that deals with the influence of genetic variation on drug response by correlating gene expression and gene variants with the efficacy or toxicity of drugs. The principle drugs in stroke medicine are antithrombotics. The aim of this paper was to review the most commonly used drugs for stroke such as rtPA in the acute phase as well as antiplatelets and wafarin for secondary prophylaxis.
循环系统疾病每年导致 1500 万人死亡，其中中风导致 450 万人死亡——每年估计有 900 万中风幸存者。中风的总发病率为每千名成年人 2 至 2.5 例，患病率约为 5 例，估计 5 年内中风复发风险为 15%至 40%。中风的传统危险因素包括：年龄增长、高血压、糖尿病、吸烟、体重指数增加、缺血性心脏病、心力衰竭、心房颤动和缺乏身体活动。年龄是缺血性和出血性中风的最强危险因素，在 55 岁以后，每增加一个十年，发病率就会增加一倍。然而，有相当一部分患有严重脑血管疾病的患者没有任何这些中风危险因素，这导致人们猜测还有其他尚未确定的因素。为了改善诊断和治疗策略，以及减轻相关的公共卫生负担，成功识别其极其复杂的遗传决定因素（多基因，多个基因起作用）可能会有所帮助。药物遗传学是药理学的一个领域，它通过将基因表达和基因变异与药物的疗效或毒性相关联，来研究遗传变异对药物反应的影响。中风医学中的主要药物是抗血栓药物。本文的目的是回顾中风中最常用的药物，如急性阶段的 rtPA 以及用于二级预防的抗血小板药物和华法林。
