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抗血小板治疗后缺血性卒中血小板反应的重要性:获益与风险之间——系统评价。

The Importance of Platelets Response during Antiplatelet Treatment after Ischemic Stroke-Between Benefit and Risk: A Systematic Review.

机构信息

Research and Education Unit for Experimental Biotechnology, Department of Transplantology and General Surgery, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland.

Department of Laboratory Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland.

出版信息

Int J Mol Sci. 2022 Jan 18;23(3):1043. doi: 10.3390/ijms23031043.

Abstract

Ischemic stroke is a disease related to abnormal blood flow that leads to brain dysfunction. The early and late phases of the disease are distinguished. A distinction is made between the early and late stages of the disease, and the best effect in treating an ischemic stroke is usually achieved within the first hours after the onset of symptoms. This review looked at studies platelet activity monitoring studies to determine the risks and benefits of various approaches including antiplatelet therapy. A study was conducted on recently published literature based on PRISMA. This review includes 32 research articles directly addressing the importance of monitoring platelet function during antiplatelet therapy (dual or monotherapy) after ischemic stroke. In patients with transient ischemic attack or ischemic stroke, antiplatelet therapy can reduce the risk of stroke by 11-15%, assuming that patients respond well. Secondary prevention results are dependent on platelet reactivity, meaning that patients do not respond equally to antiplatelet therapy. It is very important that aspirin-resistant patients can benefit from the use of dual antiplatelet therapy. The individualized approach to secondary stroke prevention is to administer the most appropriate drug at the correct dose and apply the optimal therapeutic procedure to the individual patient.

摘要

缺血性脑卒中是一种与异常血流相关的疾病,可导致脑功能障碍。该病有早晚期之分。该病分为早晚期,在症状出现后的最初几小时内进行治疗通常效果最佳。本综述对血小板活性监测研究进行了评估,以确定各种方法(包括抗血小板治疗)的风险和益处。该研究基于 PRISMA 对最近发表的文献进行了评估。本综述共纳入 32 篇直接探讨缺血性脑卒中后(双联或单联)抗血小板治疗期间监测血小板功能重要性的研究文章。对于短暂性脑缺血发作或缺血性脑卒中患者,抗血小板治疗可以降低 11-15%的脑卒中风险,前提是患者对治疗有良好的反应。二级预防结果取决于血小板反应性,即患者对抗血小板治疗的反应并不相同。对于阿司匹林抵抗患者来说,双联抗血小板治疗的获益非常重要。对二级卒中预防进行个体化处理的方法是,给患者使用最合适的药物,并给予最合适的剂量,同时对每个患者应用最佳的治疗程序。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b65b/8835275/d18e75c3428f/ijms-23-01043-g001.jpg

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