Paoletti R, Maderna P, Tremoli E
J Cardiovasc Pharmacol. 1985;7 Suppl 3:S179-85. doi: 10.1097/00005344-198500073-00021.
Disturbances in the balance between the production of thromboxane A2 by the platelets and that of prostacyclin by the vessel wall may play a major role in disease and be a target for therapeutic agents. Acetylsalicylic acid, given in small doses, may inhibit the production of thromboxane A2 without affecting that of prostacyclin. Even if it reduces prostacyclin synthesis, the drug is beneficial as an antithrombotic agent, possibly because it has actions not related to inhibition of cyclooxygenase. Dazoxiben not only inhibits the production of thromboxane A2 by platelets, but also facilitates that of prostanoids, in part by diverting endoperoxides to the blood vessel wall and to leukocytes. Although reduced production of prostacyclin may contribute to the etiology of atherosclerosis, the blood vessel wall of hypercholesterolemic animals exhibits an increased production of prostacyclin. The latter has been given successfully in patients with accelerated turnover of platelets or with peripheral vascular disease. However, its very short t1/2 limits its practical use. The availability of stable prostacyclin derivates, such as ZK 36374, may bypass this problem.
血小板产生血栓素A2与血管壁产生前列环素之间的平衡失调可能在疾病中起主要作用，并且是治疗药物的作用靶点。小剂量给予乙酰水杨酸可能抑制血栓素A2的产生而不影响前列环素的产生。即使它会减少前列环素的合成，该药物作为抗血栓形成剂仍是有益的，这可能是因为它具有与抑制环氧化酶无关的作用。达唑氧苯不仅抑制血小板产生血栓素A2，还部分通过将内过氧化物转移至血管壁和白细胞来促进类前列腺素的产生。尽管前列环素产生减少可能促成动脉粥样硬化的病因，但高胆固醇血症动物的血管壁前列环素产生增加。前列环素已成功用于血小板周转加快或患有外周血管疾病的患者。然而，其极短的半衰期限制了其实际应用。稳定的前列环素衍生物（如ZK 36374）的可用性可能会绕过这个问题。
