急性脑梗死静脉溶栓/桥接治疗24 h内血小板活化的研究进展
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(湖南省人民医院 湖南师范大学第一附属医院神经内科,湖南省长沙市 410005)

作者简介:

李雪梅,硕士,住院医师,研究方向为脑血管病,E-mail为153627709@qq.com。通信作者赵志鸿,硕士,主任医师,教授,研究方向为脑血管病、神经介入,E-mail为1019200187@qq.com。

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湖南省卫生计生委科研计划课题项目(B20180797);湖南省临床医疗技术创新引导计划项目(2017SK50512)


Research progress of intravenous thrombolysis/bridging in the treatment of platelet activation within 24 hours of acute cerebral infarction
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Hunan Provincial People's Hospital, the Neurology Department of the First Affiliated Hospital of Hunan Normal University, Changsha, Hunan 410005, China)

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    摘要:

    急性脑梗死目前最理想的治疗是尽快使闭塞的血管再通,静脉溶栓治疗是急性脑梗死确证有效的开通闭塞动脉的急救措施,桥接治疗提高了闭塞血管的再通机率,但仍有一部分患者存在残余血管狭窄。已知血小板在急性脑梗死的发生和发展中起着重要作用。溶栓/桥接治疗后导致血管再通后再闭塞的关键因素之一是溶栓后24 h内禁止抗血小板聚集药物的使用,血小板的聚集与活化使一部分残余动脉狭窄患者发生了动脉再闭塞。本文针对血小板活化机制及近年来关于急性脑梗死静脉溶栓/桥接治疗后血小板活化状态及抗血小板治疗联合静脉溶栓/桥接治疗的研究进行综述,以探讨在静脉溶栓/桥接治疗后24 h内使用抗血小板聚集药物的可行性及安全性,从而改善患者的预后。

    Abstract:

    The most ideal treatment for acute cerebral infarction is the recanalization of occlusive vessels as soon as possible. Intravenous thrombolytic therapy is an effective treatment for acute cerebral infarction. Bridging therapy improves the recanalization rate of occlusive vessels, but there are still some patients with residual vascular stenosis. Platelets are known to play an important role in the occurence and development of acute cerebral infarction. One of the key factors for reocclusion of blood vessels after thrombolytic / bridging treatment is the prohibition of antiplatelet aggregation within 24 hours after thrombolytic therapy. Platelet aggregation and activation make a part of the patients with residual artery stenosis reoccluded. Inorder to explore the feasibility and safety of using antiplatelet drugs within 24 hours after intravenous thrombolysis/bridging treatment and improving the prognosis of patients, this paper reviewed the mechanism of platelet activation and the platelet activation status after intravenous thrombolysis/bridging therapy in acute cerebral infarction and the related research of antiplatelet combined with intravenous thrombolysis/bridging therapy.

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李雪梅,赵志鸿.急性脑梗死静脉溶栓/桥接治疗24 h内血小板活化的研究进展[J].中国动脉硬化杂志,2019,27(5):445~450.

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  • 收稿日期:2018-08-23
  • 最后修改日期:2018-11-11
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  • 在线发布日期: 2019-04-08