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血小板糖蛋白 IIb/IIIa 抑制剂在急性冠状动脉综合征治疗中的作用。

The role of platelet glycoprotein IIb / IIIa inhibitors in current treatment of acute coronary syndrome.

机构信息

National Medical Research Center of Cardiology, Moscow.

ZAO Framon, Moscow.

出版信息

Kardiologiia. 2022 Apr 30;62(4):64-72. doi: 10.18087/cardio.2022.4.n2020.

Abstract

Current management of patients with acute coronary syndrome (ACS) includes a dual antiplatelet therapy with acetylsalicylic acid and a platelet P2Y12 receptor inhibitor. For patients without a high risk of bleeding, prasugrel and ticagrelor are preferred, since their effect is more pronounced, less dependent on metabolism of a specific patient, and occurs faster that the effect of clopidogrel. The prescription rate of platelet glycoprotein IIb/IIIa (GP IIb / IIIa) receptor inhibitors has considerably decreased. However, these drugs remain relevant in percutaneous coronary interventions in patients with a high risk of coronary thrombosis or a massive coronary thrombus, in thrombotic complications of the procedure, and in the "no-reflow" phenomenon. The intravenous route of GP IIb / IIIa inhibitor administration provides their effectiveness in patients with difficulties of drug intake or with impaired absorption of oral medications. This review presents clinical and pharmacological characteristics of various GP IIb / IIIa inhibitors and data of randomized clinical studies and registries of recent years that evaluated results of their use in patients with ACS.

摘要

目前,急性冠状动脉综合征(ACS)患者的治疗包括双联抗血小板治疗,即使用乙酰水杨酸和血小板 P2Y12 受体抑制剂。对于无高出血风险的患者,推荐使用普拉格雷和替格瑞洛,因为它们的效果更显著,对特定患者代谢的依赖性更小,起效更快,优于氯吡格雷。血小板糖蛋白 IIb/IIIa(GP IIb/IIIa)受体抑制剂的处方率已大幅下降。然而,这些药物在血栓形成风险高或有大量冠状动脉血栓、血栓并发症或“无复流”现象的经皮冠状动脉介入治疗中仍然相关。GP IIb/IIIa 抑制剂的静脉途径给药可提高药物摄入困难或口服药物吸收不良患者的疗效。本文介绍了各种 GP IIb/IIIa 抑制剂的临床和药理学特性,以及近年来评估其在 ACS 患者中应用结果的随机临床试验和注册研究的数据。

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