Department of Neuroscience, Stroke Unit, University of Tor Vergata, 00133 Rome, Italy.
Curr Vasc Pharmacol. 2010 May;8(3):363-72. doi: 10.2174/157016110791112331.
The burden of atherosclerosis is particularly high in western countries in terms of mortality and disability. The cerebral arteries (stroke or transient ischemic attack [TIA]), coronary arteries (myocardial infarction [MI]) and peripheral arteries (intermittent claudication [IC], ischemic limb) can be affected. Atherosclerosis may involve different mechanisms such as inflammation, platelet activation, endothelial damage, balance between proliferation and apoptosis of smooth muscle cells and oxidative stress. Research is focused to counteract each of these aspects. Many antithrombotic drugs are currently available and most of them act as inhibitors of platelet function. Aspirin, ticlopidine, clopidogrel and the combination of aspirin plus dipyridamole are widely used for primary (in high-risk patients) and secondary prevention of atherosclerotic diseases. Research of new pharmacological strategies is driven by the need to reduce the risk of bleeding associated with the use of antiplatelet drugs. In this context cilostazol, a type III phosphodiesterase inhibitor, has demonstrated antiplatelet and vasodilator effects with low rate of bleeding complications. This review will focus on the pharmacological properties of cilostazol and its use in the management of atherothrombotic vascular diseases.
动脉粥样硬化的负担在西方国家的死亡率和残疾率方面特别高。大脑动脉（中风或短暂性脑缺血发作 [TIA]）、冠状动脉（心肌梗死 [MI]）和外周动脉（间歇性跛行 [IC]、缺血肢体）可能会受到影响。动脉粥样硬化可能涉及不同的机制，如炎症、血小板激活、内皮损伤、平滑肌细胞增殖和凋亡之间的平衡以及氧化应激。研究的重点是对抗这些方面。目前有许多抗血栓药物，其中大多数是血小板功能抑制剂。阿司匹林、噻氯匹定、氯吡格雷以及阿司匹林加双嘧达莫的联合用药广泛用于动脉粥样硬化疾病的一级（高危患者）和二级预防。由于需要降低与使用抗血小板药物相关的出血风险，因此正在研究新的药理学策略。在这种情况下，磷酸二酯酶抑制剂 3 型 cilostazol 已被证明具有抗血小板和血管扩张作用，出血并发症发生率低。这篇综述将重点介绍 cilostazol 的药理学特性及其在动脉粥样硬化血栓形成性血管疾病管理中的应用。
