氯吡格雷抵抗的现状与展望

氯吡格雷是一种广泛用于冠心病患者的抗血小板药物。但是氯吡格雷不是对所有病人都有同样效果。有些病人尽管进行了氯吡格雷治疗,依然发生了不良事件。这可以被氯吡格雷的抗血小板凝集能力下降所部分解释。一个离体研究定义这一现象为氯吡格雷无应答或抵抗。然而不管是流行病学资料还是和冠心病风险的相关性都不明朗。现对氯吡格雷抵抗的定义、影响因子、临床意义及解决的途径和问题做一综述。

Clopidogrel Resistance

Clopidogrel is the most widely used platelet aggregation inhibitor in cardiovascular patients. However, not all individuals respond in the same way to clopidogrel ; there are patients who suffer adverse events in spite of clopidogrel treatment. This could be partly ex- plained by a reduced efficacy of clopidogrel to inhibit platelet aggregation, an ex vivo defined phenomenon called clopidogrel nonresponsiveness, or resistance. However, both prevalence and associated cardiovascular risks remain unclear. This review tocuses on the definition, potential mechanisms, and clinical implications of elopidogrel resistance, as well as ways to improve the response to this antiplatelet drug.