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首页> 外文期刊>Current topics in medicinal chemistry >Antiplatelet treatment in ischemic stroke treatment.
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Antiplatelet treatment in ischemic stroke treatment.

机译：缺血性中风的抗血小板治疗。

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Antiplatelets represent a diverse group of agents that share the ability to reduce platelet activity through a variety of mechanisms. Antithrombotic agents are effective in the secondary prevention of ischemic strokes. Most strokes are caused by a sudden blockage of an artery in the brain (called an ischaemic stroke) that is usually due to a blood clot. Immediate treatment with antiplatelet drugs such as aspirin may prevent new clots from forming and hence improve recovery after stroke. Several studies have evaluated the role of one antiplatelet agent, aspirin, in reducing stroke severity. The International Stroke Trial (IST) of 20,000 patients with acute stroke from other countries. In this study there was a significant 14% proportional reduction in mortality during the scheduled treatment period (343 [3.3%] deaths among aspirin-allocated patients vs 398 [3.9%] deaths among placebo-allocated patients; 2p = 0.04). There were significantly fewer recurrent ischaemic strokes in the aspirin-allocated than in the placebo-allocated group (167 [1.6%] vs 215 [2.1%]; 2p = 0.01) but slightly more haemorrhagic strokes (115 [1.1%] vs 93 [0.9%]. Few studies examined the role of ticlopidin in acute stroke setting the results showed treatment with ticlopidine improved the neurologic outcome. In the Examining the Safety of Loading of Aspirin and Clopidogrel in Acute Ischemic Stroke and TIA (LOAD) study, 40 consecutive ischemic stroke patients were treated with 325 mg of aspirin and 375 mg of clopidogrel within 36 hours of symptom onset. Overall, 37.5% (n = 15) of the patients had an improvement of 2 or more points on the NIHSS 24 hours after antiplatelet administration. The antiplatelet efficacy of aspirin in preventing secondary stroke was established by three studies conducted in the late 1980s and early 1990s: the Swedish Aspirin Low-dose Trial (SALT) trials have demonstrated that aspirin-even in doses as low as 30 mg/day-reduces secondary stroke, MI, or vascular death in patients with. Clopidogrel and aspirin have been used in combination in patients with diverse arterial vascular diseases However, combinations of antithrombotic agents do not necessarily improve clinical efficacy and are typically associated with increased toxicity.
机译：抗血小板代表了多种药物，它们具有通过各种机制降低血小板活性的能力。抗血栓药可有效预防缺血性中风。大多数中风是由于大脑中的动脉突然阻塞（称为缺血性中风）引起的，通常是由于血块引起的。立即使用抗血小板药物（例如阿司匹林）进行治疗可防止形成新的血块，从而改善中风后的恢复。几项研究评估了一种抗血小板药阿司匹林在降低卒中严重程度中的作用。来自其他国家的20,000名急性中风患者的国际中风试验（IST）。在这项研究中，按计划的治疗期间死亡率显着降低了14％（分配阿司匹林的患者中有343例死亡[3.3％]，而使用安慰剂的患者中有398例[3.9％]死亡; 2p = 0.04）。分配阿司匹林的复发性缺血性卒中明显少于安慰剂组（167 [1.6％] vs 215 [2.1％]; 2p = 0.01），但出血性卒中略多（115 [1.1％] vs 93 [ 0.9％]。很少有研究检查噻氯匹定在急性脑卒中中的作用，结果显示噻氯匹定治疗可改善神经系统结局。在急性缺血性卒中和TIA研究中检查阿司匹林和氯吡格雷负荷的安全性，连续40次缺血性卒中患者在症状发作后36小时内接受325 mg阿司匹林和375 mg氯吡格雷治疗，总体上，抗血小板药物治疗24小时后，有37.5％（n = 15）的患者NIHSS改善了2点或更多点阿司匹林预防继发性中风的抗血小板功效是由1980年代末和1990年代初进行的三项研究确定的：瑞典阿司匹林低剂量试验（SALT）试验表明，阿司匹林即使在低剂量下也是如此。 w为30毫克/天，可减少患有HBV的患者的继发性中风，MI或血管死亡。氯吡格雷和阿司匹林已被组合用于多种动脉血管疾病的患者。但是，抗血栓形成剂的组合不一定能改善临床疗效，并且通常会增加毒性。

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