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西洛他唑用于卒中二级预防:指南是否应予以扩展?

Cilostazol for Secondary Prevention of Stroke: Should the Guidelines Perhaps Be Extended?

作者信息

Galyfos George, Sianou Argyri

机构信息

Division of Vascular Surgery, Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece.

Department of Microbiology, University of Athens Medical School, Areteion Hospital, Athens, Greece.

出版信息

Vasc Specialist Int. 2017 Sep;33(3):89-92. doi: 10.5758/vsi.2017.33.3.89. Epub 2017 Sep 30.

DOI:10.5758/vsi.2017.33.3.89
PMID:28955697
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5614376/
Abstract

Cilostazol belongs to the new generation antiplatelet agents that have been introduced and studied regarding a potential role in cardiovascular disease prevention or treatment. Although data on peripheral artery disease are sufficient, and the drug has been recommended as first line treatment for intermittent claudication, it has not been approved nor recommended as far as cerebrovascular events are concerned. However, a great volume of randomized as well as pooled data has been published during the last years. Therefore, this review aims to describe the basic mechanisms of cilostazol's action as well as to present all recent clinical data in order to conclude on whether official guidelines should be extended.

摘要

西洛他唑属于新一代抗血小板药物,这类药物已被引入并就其在心血管疾病预防或治疗中的潜在作用进行了研究。尽管关于外周动脉疾病的数据充足,且该药物已被推荐为间歇性跛行的一线治疗药物,但就脑血管事件而言,它尚未获得批准或推荐。然而,在过去几年中已经发表了大量的随机数据以及汇总数据。因此,本综述旨在描述西洛他唑的基本作用机制,并呈现所有最新的临床数据,以便得出是否应扩展官方指南的结论。

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Cilostazol for Secondary Prevention of Stroke: Should the Guidelines Perhaps Be Extended?西洛他唑用于卒中二级预防:指南是否应予以扩展?
Vasc Specialist Int. 2017 Sep;33(3):89-92. doi: 10.5758/vsi.2017.33.3.89. Epub 2017 Sep 30.
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Cilostazol for treatment of cerebral infarction.西洛他唑治疗脑梗死。
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Atheroscler Suppl. 2005 Dec 15;6(4):21-31. doi: 10.1016/j.atherosclerosissup.2005.09.004. Epub 2005 Nov 4.
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Cilostazol: a new drug in the treatment intermittent claudication.西洛他唑:治疗间歇性跛行的一种新药。
Recent Pat Cardiovasc Drug Discov. 2007 Nov;2(3):181-5. doi: 10.2174/157489007782418991.
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Cilostazol for peripheral arterial disease.西洛他唑用于治疗外周动脉疾病。
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Cilostazol for peripheral arterial disease.西洛他唑用于治疗外周动脉疾病。
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Cilostazol: treatment of intermittent claudication.西洛他唑:治疗间歇性跛行。
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Treatment Approaches to Lacunar Stroke.腔隙性卒中的治疗方法
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本文引用的文献

1
Protective effects of cilostazol against hemorrhagic stroke: Current and future perspectives.西洛他唑对出血性中风的保护作用:现状与未来展望。
J Pharmacol Sci. 2016 Jul;131(3):155-61. doi: 10.1016/j.jphs.2016.04.023. Epub 2016 May 3.
2
Cilostazol reduces blood brain barrier dysfunction, white matter lesion formation and motor deficits following chronic cerebral hypoperfusion.西洛他唑可减轻慢性脑灌注不足后的血脑屏障功能障碍、白质病变形成及运动功能缺损。
Brain Res. 2016 Sep 1;1646:494-503. doi: 10.1016/j.brainres.2016.06.036. Epub 2016 Jun 24.
3
Effect of Cilostazol on Cerebral Vasospasm and Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage: A Randomized, Double-Blind, Placebo-Controlled Trial.西洛他唑对动脉瘤性蛛网膜下腔出血患者脑血管痉挛及预后的影响:一项随机、双盲、安慰剂对照试验
Cerebrovasc Dis. 2016;42(1-2):97-105. doi: 10.1159/000445509. Epub 2016 Apr 13.
4
Antiplatelet regimens in the long-term secondary prevention of transient ischaemic attack and ischaemic stroke: an updated network meta-analysis.短暂性脑缺血发作和缺血性卒中长期二级预防中的抗血小板治疗方案:一项更新的网状Meta分析
BMJ Open. 2016 Mar 17;6(3):e009013. doi: 10.1136/bmjopen-2015-009013.
5
Antiplatelet Agents for the Secondary Prevention of Ischemic Stroke or Transient Ischemic Attack: A Network Meta-Analysis.抗血小板药物用于缺血性卒中或短暂性脑缺血发作的二级预防:一项网状Meta分析。
J Stroke Cerebrovasc Dis. 2016 May;25(5):1081-1089. doi: 10.1016/j.jstrokecerebrovasdis.2016.01.026. Epub 2016 Feb 5.
6
Induction of Angiogenesis by a Type III Phosphodiesterase Inhibitor, Cilostazol, Through Activation of Peroxisome Proliferator-Activated Receptor-γ and cAMP Pathways in Vascular Cells.III型磷酸二酯酶抑制剂西洛他唑通过激活血管细胞中的过氧化物酶体增殖物激活受体γ和cAMP途径诱导血管生成
Arterioscler Thromb Vasc Biol. 2016 Mar;36(3):545-52. doi: 10.1161/ATVBAHA.115.307011. Epub 2016 Jan 14.
7
Cilostazol ameliorates collagenase-induced cerebral hemorrhage by protecting the blood-brain barrier.西洛他唑通过保护血脑屏障改善胶原酶诱导的脑出血。
J Cereb Blood Flow Metab. 2017 Jan;37(1):123-139. doi: 10.1177/0271678X15621499. Epub 2015 Dec 1.
8
Meta-Analysis of Studies Evaluating the Effect of Cilostazol on Major Outcomes After Carotid Stenting.评估西洛他唑对颈动脉支架置入术后主要结局影响的研究的Meta分析。
J Endovasc Ther. 2016 Feb;23(1):186-95. doi: 10.1177/1526602815619409. Epub 2015 Nov 30.
9
Long-Term Antiplatelet Mono- and Dual Therapies After Ischemic Stroke or Transient Ischemic Attack: Network Meta-Analysis.缺血性中风或短暂性脑缺血发作后的长期抗血小板单药治疗和双联治疗:网状Meta分析
J Am Heart Assoc. 2015 Aug 24;4(8):e002259. doi: 10.1161/JAHA.115.002259.
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Efficacy and Safety of Cilostazol Therapy in Ischemic Stroke: A Meta-analysis.西洛他唑治疗缺血性卒中的疗效与安全性:一项荟萃分析。
J Stroke Cerebrovasc Dis. 2015 May;24(5):930-8. doi: 10.1016/j.jstrokecerebrovasdis.2014.12.002. Epub 2015 Mar 21.