Jung Jung Hwa, Tantry Udaya S, Gurbel Paul A, Jeong Young-Hoon
Division of Endocrinology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
Sinai Center for Thrombosis Research, Baltimore, MD, USA.
Diabetes Metab J. 2015 Apr;39(2):95-113. doi: 10.4093/dmj.2015.39.2.95.
Patients with diabetes mellitus (DM) have accelerated atherosclerosis with an increased risk for atherothrombotic cardiovascular complications. A state of high platelet reactivity and activation, hypercoagulability (prothrombotic state) and a subdued response to standard antiplatelet agents may explain high rate of adverse cardiovascular events in patients with DM. Several antithrombotic treatment strategies have been developed to control the prothrombotic state in patients with DM: dose modification of commonly used agents; use of potent agents; and addition of a third antithrombotic drug (triple therapy) to commonly prescribed dual antiplatelet therapy of aspirin and a P2Y12 inhibitor. The present review aims to provide an overview of the current knowledge on platelet abnormalities in patients with DM, focusing on the challenges and perspectives of antiplatelet treatment strategies in this population.
糖尿病（DM）患者的动脉粥样硬化进程加速，发生动脉粥样硬化性心血管并发症的风险增加。血小板高反应性和活化状态、高凝状态（血栓前状态）以及对标准抗血小板药物反应减弱，可能解释了DM患者心血管不良事件发生率较高的原因。已制定了几种抗栓治疗策略来控制DM患者的血栓前状态：常用药物的剂量调整；强效药物的使用；以及在常用的阿司匹林和P2Y12抑制剂双联抗血小板治疗基础上加用第三种抗栓药物（三联疗法）。本综述旨在概述目前关于DM患者血小板异常的知识，重点关注该人群抗血小板治疗策略面临的挑战和前景。
