Cervinka P
Kardiocentrum FN, Hradec Králové.
Vnitr Lek. 1998 Jul;44(7):439-43.
Acute coronary syndromes (unstable angina pectoris, acute myocardial infarction) are still the main cause of mortality and morbidity not only in economically advanced countries. Although coronary angioplasty has become modern treatment of stable angina as well as of acute coronaries, acute occlusion of the vessel is still a serious problem. The prognosis of patients undergoing coronary angioplasty can be substantially improved by accurate evaluation of the risk of possible complications during or shortly after the procedure and by development of more effective anticoagulants. Research provided evidence that platelets play a decisive role in the formation of occlusive thrombi and that the thrombocyte glycoproteins IIb/IIIa are the basic mediator of platelet aggregation. Newly developed inhibitors of these receptors reduce acute ischaemic complications after percutaneous transluminal coronary angioplasty. Conclusions of various trials support the inclusion of glycoprotein IIb/IIIa inhibitors in the standard therapeutic protocol of patients undergoing coronary angioplasty, in particular those with a high risk because of acute occlusion of the vessel after operation.
急性冠状动脉综合征（不稳定型心绞痛、急性心肌梗死）不仅在经济发达国家仍是导致死亡和发病的主要原因。尽管冠状动脉血管成形术已成为稳定型心绞痛以及急性冠状动脉疾病的现代治疗方法，但血管急性闭塞仍然是一个严重问题。通过准确评估手术期间或术后不久可能出现并发症的风险以及研发更有效的抗凝剂，可大幅改善接受冠状动脉血管成形术患者的预后。研究表明，血小板在闭塞性血栓形成中起决定性作用，血小板糖蛋白IIb/IIIa是血小板聚集的基本介质。新开发的这些受体抑制剂可减少经皮腔内冠状动脉血管成形术后的急性缺血性并发症。各种试验的结论支持将糖蛋白IIb/IIIa抑制剂纳入接受冠状动脉血管成形术患者的标准治疗方案，特别是那些因术后血管急性闭塞而具有高风险的患者。
