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抗血小板聚集药物在缺血性心脑血管疾病的防治中已获广泛应用,目前已发展到30余种。第一代药物的作用机理是降低环氧化酶活性,阻断内过氧化物生成,进一步使血栓烷A_2(TXA_2)受抑;或者是抑制磷酸二酯酶活性,提高血小板环磷腺苷(CAMP)水平,从而降低血小板的聚集性。前者的代表药物是阿斯匹林,后者的代表药物是潘生丁。第二代药物则是前列环素(PGI_2)和TXA_2拮抗剂,正常情况下,PGI_2与TXA_2呈动态平衡,当PGI_2减少或TXA_2增多时均可出现血管收缩和血小板聚集。TXA_2合成酶抑制剂的代表是咪唑类药物。此外,近年来发现钙离子拮抗剂可以影响血小板膜钙离子通道,降低其聚集性。抗血小板聚集药物的分类见附表。下面简要介绍国内外常用的一些抗血小板聚集药物,以供使用时参考。一.阿斯匹林(Aspirin) 该药系1898年首先由Hoffman氏人工合成并
Anti-platelet aggregation drugs in the prevention and treatment of ischemic cardiovascular disease has been widely used, has now grown to more than 30 species. The mechanism of action of the first generation of drugs is to reduce the activity of cyclooxygenase, block the formation of endoperoxide, and further inhibit thromboxane A2 (TXA2); or inhibit the activity of phosphodiesterase and increase the activity of platelet-derived adenosine monophosphate CAMP) levels, thereby reducing platelet aggregation. The former represents aspirin, while the latter represents dipyridamole. The second-generation drugs are prostaglandin (PGI_2) and TXA_2 antagonists. Under normal conditions, PGI_2 and TXA 2 are dynamically balanced. Vasoconstriction and platelet aggregation may occur when PGI_2 is decreased or when TXA_2 is increased. Representatives of TXA-2 synthase inhibitors are imidazoles. In addition, calcium antagonists have been found in recent years can affect the platelet membrane calcium channel, reducing its aggregation. The classification of anti-platelet aggregation drugs in the schedule. The following brief introduction of some anti-platelet aggregation drugs commonly used at home and abroad for reference when used. Aspirin (Aspirin) This medicine was first synthesized by Hoffman in 1898