Ferlito S
Istituto di Clinica Medica I, Università degli Studi, Catania.
Minerva Cardioangiol. 1996 Jun;44(6):299-312.
The author reviews the use of the main antithrombotic drugs (thrombolytics, dicumarol compounds, heparins and anti-platelet drugs) in the treatment and prophylaxis of the main nosographic syndromes of arterial and venous thrombosis. In the context of arterial thrombosis the paper initially reports the results of the main controlled trials on ischemic cardiopathy (treatment of acute infarction, primary and secondary prophylaxis for re-infarction, post-infarction ventricular thrombosis, stable and instable coronary angor, percutaneous angioplasty, aortocoronary by-pass, stent, valve prosthesis, atrial fibrillation). Turning to peripheral arteriopathies the treatment of acute attacks is death with separately from prophylactic treatment (reduction of atheromatous progression, improved vascular perfusion, reduction of concomitant cardiac and cerebral events, behaviour of carotid stenoses). Vascular cerebropathy is examined during the acute (treatment of ictus in early days) and later phases (prophylaxis of recidivation of ictus). With regard to venous thrombosis, the paper separates the treatment of profound thrombosis and pulmonary embolism (often secondary to the former) from prophylaxis of profound thrombosis; the latter is classified into forms occurring during general surgery (abdominal, pelvic, urologic), orthopedic surgery (hip prosthesis, gonopathies) and general medicine. The author ends the review by making a schematic analysis of the areas of elective use of the above antithrombotic drugs with reference to the nosographical forms examined in the paper.
作者回顾了主要抗血栓药物(溶栓剂、双香豆素类化合物、肝素和抗血小板药物)在动脉和静脉血栓形成的主要疾病综合征治疗及预防中的应用。在动脉血栓形成方面,本文首先报告了关于缺血性心脏病的主要对照试验结果(急性心肌梗死的治疗、再梗死的一级和二级预防、梗死后心室血栓形成、稳定型和不稳定型冠状动脉绞痛、经皮血管成形术、主动脉冠状动脉搭桥术、支架、瓣膜置换术、心房颤动)。接着讨论外周动脉疾病时,将急性发作的治疗与预防性治疗(减少动脉粥样硬化进展、改善血管灌注、减少并发的心脑血管事件、颈动脉狭窄的处理)分开阐述。在急性(早期卒中治疗)和后期阶段(卒中复发的预防)对外周脑血管病进行了研究。关于静脉血栓形成,本文将深部血栓形成和肺栓塞(常继发于前者)的治疗与深部血栓形成的预防分开;后者又分为普通外科手术(腹部、盆腔、泌尿外科)、骨科手术(髋关节置换术、关节病)及普通内科中出现的情况。作者通过参照本文所研究的疾病分类形式,对上述抗血栓药物的选择性应用领域进行了简要分析,从而结束了本综述。