氯吡格雷停药后血小板活性反跳现象

目前临床上常在药物洗脱支架术后持续使用阿司匹林与氯吡格雷双重抗血小板药物治疗至少1年以上以防止血栓事件。然而,一些临床研究显示,晚期或晚晚期支架内血栓常发生于中断氯吡格雷治疗之后,提示长期服用氯吡格雷后突然停药可能导致血小板凝集功能反跳。现将回顾近几年的研究进展,就氯吡格雷停药后是否存在血小板活性反跳现象作一探讨,并进一步讨论血小板活性反跳的可能潜在机制及其他假说。

Rebound Phenomenon in Platelet Activity Following Clopidogrel Withdrawal

For patients undergoing coronary drug-eluting stent placement,dual anti-platelet treatment with aspirin and clopidogrel for at least one year is the clinical therapy of choice to prevent thrombosis.However,interruption of clopidogrel treatment often precedes late stent thrombosis and very late stent thrombosis,which suggests that clopidogrel withdrawal may enhance platelet agglutination function.This article will review and discuss the possibility of platelet activity rebound phenomenon following clopidogrel withdrawal,and the potential mechanisms underlying rebound platelet activity and alternative hypotheses.