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临床已确立氯吡格雷对急性冠状动脉综合征患者保护作用,因为氯吡格雷可抑制二磷酸腺苷与血小板上的受体结合,几项大型临床试验均显示它可以有效降低动脉内血栓形成事件发生的危险,但氯吡格雷抗血小板作用并不能使所有患者受益,部分患者对氯吡格雷的心血管保护作用存在氯吡格雷抵抗现象,即应用氯吡格雷的患者仍会发生心血管血栓事件。较多因素在氯吡格雷抵抗的发病机制中起到作用,如氯吡格雷剂量不足、药物药物的反应、基因多态性等。本文就氯吡格雷抵抗的影响因素予以综述。
Clopidogrel has been clinically established in patients with acute coronary syndrome protection, because clopidogrel can inhibit adenosine diphosphate and platelet receptor binding, several large clinical trials have shown that it can effectively reduce intra-arterial thrombosis events However, the antiplatelet effect of clopidogrel does not benefit all patients. Some patients have clopidogrel resistance to the cardioprotective effect of clopidogrel. Patients with clopidogrel may still have cardiovascular thrombosis . More factors play a role in the pathogenesis of clopidogrel resistance, such as lack of dose of clopidogrel, drug drug response, gene polymorphisms and so on. This article reviews the influencing factors of clopidogrel resistance.