李岱旭, 综述, 卢 琳, 审阅. 普拉格雷在冠心病介入治疗中的研究进展[J]. 心脏杂志, 2012, 24(4): 541-543.
    引用本文: 李岱旭, 综述, 卢 琳, 审阅. 普拉格雷在冠心病介入治疗中的研究进展[J]. 心脏杂志, 2012, 24(4): 541-543.
    Application of prasugrel in coronary interventional therapy[J]. Chinese Heart Journal, 2012, 24(4): 541-543.
    Citation: Application of prasugrel in coronary interventional therapy[J]. Chinese Heart Journal, 2012, 24(4): 541-543.

    普拉格雷在冠心病介入治疗中的研究进展

    Application of prasugrel in coronary interventional therapy

    • 摘要: 口服双重抗血小板药物阿司匹林加噻吩吡啶,已获准在经皮冠状动脉介入治疗(PCI)中使用。第二代噻吩吡啶类衍生物氯吡格雷是给予PCI患者双重抗血小板治疗的选择性药物。但是,氯吡格雷存在两个缺陷:①氯吡格雷需要代谢产生其活性的形式,故抗血小板活性延迟;②已证明不同患者给予氯吡格雷后的反应存在很大差异性。为了克服氯吡格雷的上述缺陷,新一代更有效的普拉格雷(即第三代噻吩吡啶类衍生物),临床评价其可以快速起效。本文对第三代口服噻吩吡啶普拉格雷进行了综述,旨在总结普拉格雷的利弊并概述该药在临床使用中最谨慎的方案。

       

      Abstract: Dual oral antiplatelet therapy, aspirin plus thienopyridine, has been permitted to be used in percutaneous coronary intervention (PCI) procedures. Clopidogrel is the thienopyridine of choice for dual antiplatelet therapy in patients treated with PCI. However, there are two deficiencies with clopidogrel: (1) clopidogrel's antiplatelet activity is delayed because the drug needs to be metabolized into its active form, and (2) variability in patient response to clopidogrel has been confirmed. To overcome these limitations of clopidogrel, a new generation of more potent inhibitors of P2Y12 receptors with a more rapid onset of action has been introduced for clinical evaluation. This article, a nonexhaustive review of the literature on prasugrel, a third-generation oral thienopyridine, summarizes the current knowledge about the benefits and risks of prasugrel and outlines the most prudent strategies for clinical use of this drug.

       

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