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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2017年第6期

页码:

721-725,730

栏目:

综述

出版日期:

2017-06-01

文章信息/Info

Title:

Advances in antithrombotic therapy in acute coronary syndrome patients with chronic renal insufficiency

作者:

张 亮¹; 袁 铭¹; 曹 丰²

（1.第四军医大学西京医院心血管内科，陕西 西安 710032;
2.中国人民解放军总医院心内科，北京 100853)

Author(s):

ZHANG Liang¹;  YUAN Ming¹;  CAO Feng²

(1.Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China;
2.Department of Cardiology, PLA General Hospital, Beijing 100853, China)

关键词:

急性冠脉综合征; 慢性肾功能不全; 抗栓治疗

Keywords:

acute coronary syndrome;  chronic renal insufficient;  antithrombotic therapy

分类号:

R543.3

DOI:

-

文献标识码:

A

摘要:

急性冠脉综合征（ACS）是严重威胁人类健康的重大疾病。慢性肾功能不全（CKD）已经成为ACS的高危因素，并且与不良心血管事件预后高度相关。抗血小板治疗对于ACS患者的早期以及远期预后至关重要，但是由于大多数药物经肾脏代谢，更重要的是CKD即存在出血倾向，同时又有高凝状态，因此更加合理的抗栓治疗对这类患者更为重要。由于大多数关于ACS抗血小板药物的大型临床研究将其作为排除标准，进而使得可用于指导CKD并发ACS患者抗血小板治疗的循证医学证据有限，为该类患者的治疗和管理带来临床的困惑。基于此，本文将近期的ACS并发CKD患者抗栓治疗临床研究进展作一综述。

Abstract:

Acute coronary syndrome (ACS) is a threatening disease and even worse when chronic kidney disease (CKD) is prevalent, which affects an ever-increasing proportion of ACS patients and is closely associated with major adverse cardiovascular events. Dual antiplatelet therapy is very important for early and long-term prognosis in ACS patients. As most drugs are eliminated by kidneys and patients with chronic renal insufficiency often have bleeding tendency and hypercoagulability states, proper use of antithrombotic drugs is significantly important for these patients. Most large randozmized controlled trials exclude those patients with CKD, making medical evidence for this subpopulation needing ACS antiplatelet therapy limited. This manuscript reviews studies concerning antithrombotic therapy for CKD with ACS.

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备注/Memo

备注/Memo:

收稿日期：2016-03-14.基金项目：陕西省科技攻关计划课题资助(52016YZSF0666)
通讯作者：袁铭，副教授，主要从事冠心病基础和复杂冠脉介入治疗研究 Email:yuanming@fmmu.edu.cn
共同通讯作者：曹丰，教授，主要从事冠心病诊治疗和心血管分子影像学研究 Email:fengcao8828@163.com
作者简介：张亮，硕士生 Email:zhangliang199096@163.com

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更新日期/Last Update: 2017-06-06