Division of Hematology/Oncology, UT Southwestern Medical Center, Dallas, TX.
Division of Hematology/Oncology, UT Southwestern Medical Center, Dallas, TX; Division of Transfusion Medicine and Hemostasis, UT Southwestern Medical Center, Dallas, TX.
Transfus Med Rev. 2019 Apr;33(2):92-97. doi: 10.1016/j.tmrv.2019.01.002. Epub 2019 Jan 25.
Antiplatelet therapy is extensively used in the primary and secondary prophylaxis of arterial thrombotic disorders. Aspirin, the most commonly used antiplatelet agent, is a cyclooxygenase-1 inhibitor and considered a mild to moderate inhibitor of platelet function. Therefore, often a second antiplatelet agent is necessary in certain clinical conditions requiring greater inhibition of platelet function. An adenosine diphosphate (ADP) receptor, P2Y12, is an important target for this purpose; several agents inhibit this receptor providing potent antiplatelet effect. One of the side effects of these agents is bleeding, which in some patients may require reversal of antiplatelet effect. Similarly, patients undergoing emergent surgeries may benefit from reversal of antiplatelet effect to avoid excessive surgical bleeding. This article reviews current literature on this topic.
抗血小板治疗广泛应用于动脉血栓性疾病的一级和二级预防。阿司匹林是最常用的抗血小板药物,它是环氧化酶-1 抑制剂,被认为是一种轻度至中度的血小板功能抑制剂。因此,在某些需要更强的血小板功能抑制的临床情况下,通常需要第二种抗血小板药物。一种二磷酸腺苷(ADP)受体 P2Y12 是达到这一目的的重要靶点;几种药物可抑制该受体,从而产生强大的抗血小板作用。这些药物的副作用之一是出血,在某些患者中可能需要逆转抗血小板作用。同样,接受紧急手术的患者可能受益于逆转抗血小板作用,以避免过度的手术出血。本文综述了这一主题的现有文献。