在神经干预中使用抗血小板疗法
Alice Ma1, Harshil Dharamdasani Detaram1, Brendan Steinfort1
1Department of Neurosurgery, Royal North Shore Hospital, St. Leonards, New South Wales, Australia.
Seminars in neurology
|August 10, 2023
概括
抗血小板药物在神经干预中至关重要,但证据有限. 标准化方案和血小板功能测试可以指导中风和动脉瘤干预的治疗决策.
科学领域:
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
- 心血管医学 心血管医学
背景情况:
- 抗血小板治疗是神经干预的组成部分,旨在预防和减少血小板聚合.
- 目前的做法往往涉及双重抗血小板疗法,包括克洛皮多格雷尔和诸如普拉苏格雷尔或提卡格雷罗尔之类的药物.
研究的目的:
- 审查抗血小板药物在神经干预中的使用.
- 检查临床指示,药理动力学,药理动力学和内血管器械.
- 确定证据缺口和未来的研究方向.
主要方法:
- 随机对照试验和大型病例系列的审查.
- 对抗血小板治疗方案的分析,包括双重抗血小板治疗和糖蛋白IIB/IIIA抑制剂.
- 在神经干预手术中进行血小板功能测试的讨论.
主要成果:
- 在对急性大血管封闭性中风的随机试验中显示的有限益处.
- 主要来自急性/选择性支架和动脉瘤治疗的病例系列的证据.
- 越来越多地使用双重抗血小板治疗和血小板功能测试.
结论:
- 神经干预中的抗血小板决策是复杂的,需要更多的随机对照试验.
- 对比性试验对于指导急性和选择性治疗策略至关重要.
- 标准化的血小板功能测试协议可以帮助临床决策等待进一步证据.
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