抗血小板疗法在老年急性冠脉综合征的临床应用

虽然大多数抗血小板疗法治疗急性冠脉综合征（ACS）的临床试验证实有显著临床效益，但老年患者，特别是≥75岁患者，仅少数有效，多数疗效欠佳，而出血风险增加。本文对因老龄化导致的止血血栓与出血的病理生物学，血管修复与整合作用变化，以及ACS抗血小板疗法在近年来临床试验中老年患者的效益与风险进行讨论。

Clinical application of antiplatelet therapy in elderly patients with acute coronary syndrome

Although majority clinical trials of antiplatelet therapy in patients with acute coronary syndrome（ACS） showed significant benefits, but in elderly patients, especially ≥75 years, the outcomes mostly were less effective, the bleeding risk increased. This review will discuss briefly the pathobiology of hemostasis, thrombosis and hemorrhage due to aging, and the changes of vascular repair and integrity, and the clinical benefit and bleeding risk of antiplatelet therapy in elderly patients with ACS in recent clinical trials.