1.遵义医科大学附属医院神经内科,遵义 563000
2.贵州省人民医院神经内科,贵阳 550002
3.贵州中医药大学第二附属医院神经内科,贵阳 550002
Received:29 April 2024,
Revised:2024-06-25,
Accepted:22 July 2024,
Published:28 December 2024
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习亚州,田雨,范宽,等.抗血小板聚集药物治疗脑小血管病的研究进展[J].重庆医科大学学报,2024,49(12):1545-1549.
Xi Yazhou,Tian Yu,Fan Kuan,et al.Research advances in the treatment of cerebral small vessel disease with anti-platelet aggregation drugs[J].Journal of Chongqing Medical University,2024,49(12):1545-1549.
习亚州,田雨,范宽,等.抗血小板聚集药物治疗脑小血管病的研究进展[J].重庆医科大学学报,2024,49(12):1545-1549. DOI: 10.13406/j.cnki.cyxb.003685.
Xi Yazhou,Tian Yu,Fan Kuan,et al.Research advances in the treatment of cerebral small vessel disease with anti-platelet aggregation drugs[J].Journal of Chongqing Medical University,2024,49(12):1545-1549. DOI: 10.13406/j.cnki.cyxb.003685.
脑小血管病(cerebral small vessel disease,CSVD)是引发痴呆和卒中的常见病因。CSVD发病机制复杂,目前尚缺乏特异的治疗药物,以防治高危因素及对症治疗为主。近年来,CSVD在抗血小板聚集药物治疗方面发展迅速,本文结合国内外最新研究成果,对抗血小板聚集药物治疗CSVD研究进展进行综述,以期为临床规范应用抗血小板聚集药物治疗CSVD提供参考。
Cerebral small vessel disease(CSVD) is a common cause of dementia and stroke,with a pathogenesis that is complex and lacks specific therapeutic drugs. Current management methods primarily involve preventing and controlling high-risk factors and symptomatic treatment. In recent years,rapid advancement in the treatment of CSVD with anti-platelet aggregation drugs has been observed. In this article,we review the research advances in the treatment of CSVD with anti-platelet aggregation drugs through analysis of the latest research results in China and globally,providing a reference for standardized treatment of CSVD using these drugs.
Duering M , Biessels GJ , Brodtmann A , et al . Neuroimaging standards for research into small vessel disease-advances since 2013 [J ] . Lancet Neurol , 2023 , 22 ( 7 ): 602 - 618 .
Chojdak-Łukasiewicz J , Dziadkowiak E , Zimny A , et al . Cerebral small vessel disease:a review [J ] . Adv Clin Exp Med , 2021 , 30 ( 3 ): 349 - 356 .
Hachinski V , Einhäupl K , Ganten D , et al . Preventing dementia by preventing stroke:The Berlin Manifesto [J ] . Alzheimers Dement , 2019 , 15 ( 7 ): 961 - 984 .
吴 波 , 刘 鸣 . 重视急性脑小血管病的诊治与研究 [J ] . 中华神经科杂志 , 2021 , 54 ( 10 ): 983 - 993 .
Wu B , Liu M . Importance of the diagnosis,treatment and research of acute cerebral small vessel disease [J ] . Chin J Neurol , 2021 , 54 ( 10 ): 983 - 993 .
Guo YQ , Li YP , Liu XK , et al . Assessing the effectiveness of statin therapy for alleviating cerebral small vessel disease progression in people ≥75 years of age [J ] . BMC Geriatr , 2020 , 20 ( 1 ): 292 .
中华医学会神经病学分会 , 中华医学会神经病学分会脑血管病学组 . 中国脑小血管病诊治指南2020 [J ] . 中华神经科杂志 , 2022 , 55 ( 8 ): 807 - 818 .
Chinese Society of Neurology , Chinese Stroke Society . Chinese guideline for diagnosis and treatment of cerebral small vessel disease 2020 [J ] . Chin J Neurol , 2022 , 55 ( 8 ): 807 - 818 .
Pantoni L . Cerebral small vessel disease:from pathogenesis and clinical characteristics to therapeutic challenges [J ] . Lancet Neurol , 2010 , 9 ( 7 ): 689 - 701 .
Bradley CP , Berry C . Microvascular arterial disease of the brain and the heart:a shared pathogenesis [J ] . QJM , 2023 , 116 ( 10 ): 829 - 834 .
武 燕 , 李 敏 , 蔺洪翔 , 等 . 缺血性脑卒中抗血小板治疗的研究进展 [J ] . 中国全科医学 , 2015 , 18 ( 23 ): 2865 - 2869 .
Wu Y , Li M , Lin HX , et al . Research progress on anti- platelet therapy for ischemic stroke [J ] . Chin Gen Pract , 2015 , 18 ( 23 ): 2865 - 2869 .
Regenhardt RW , Das AS , Lo EH , et al . Advances in understanding the pathophysiology of lacunar stroke:a review [J ] . JAMA Neurol , 2018 , 75 ( 10 ): 1273 - 1281 .
Park JH , Kwon SU , Kwon HS , et al . Prior intracerebral hemorrhage and white matter hyperintensity burden on recurrent stroke risk [J ] . Sci Rep , 2021 , 11 ( 1 ): 17406 .
Sohn JH , Kim C , Sung JH , et al . Effect of pre-stroke antiplatelet use on stroke outcomes in acute small vessel occlusion stroke with moderate to severe white matter burden [J ] . J Neurol Sci , 2024 , 456 : 122837 .
刘丽萍 , 周宏宇 , 段婉莹 , 等 . 中国脑血管病临床管理指南(第2版)(节选):第4章 缺血性脑血管病临床管理推荐意见 [J ] . 中国卒中杂志 , 2023 , 18 ( 8 ): 910 - 933 .
Liu LP , Zhou HY , Duan WY , et al . Chinese stroke association guidelines for clinical management of cerebrovascular diseases(second edition)(excerpt)—chapter four clinical management of ischaemic cerebrovascular diseases [J ] . Chin J Stroke , 2023 , 18 ( 8 ): 910 - 933 .
中华医学会神经病学分会 , 中华医学会神经病学分会脑血管病学组 . 中国缺血性卒中和短暂性脑缺血发作二级预防指南2022 [J ] . 中华神经科杂志 , 2022 , 55 ( 10 ): 1071 - 1110 .
Chinese Society of Neurology , Chinese Stroke Society . Chinese guideline for the secondary prevention of ischemic stroke and transient ischemic attack 2022 [J ] . Chin J Neurol , 2022 , 55 ( 10 ): 1071 - 1110 .
SPS Investigators , Benavente OR , Hart RG , et al . Effects of clopidogrel added to aspirin in patients with recent lacunar stroke [J ] . N Engl J Med , 2012 , 367 ( 9 ): 817 - 825 .
Kwok CS , Shoamanesh A , Copley HC , et al . Efficacy of antiplatelet therapy in secondary prevention following lacunar stroke:pooled analysis of randomized trials [J ] . Stroke , 2015 , 46 ( 4 ): 1014 - 1023 .
Biffi A , Halpin A , Towfighi A , et al . Aspirin and recurrent intracerebral hemorrhage in cerebral amyloid angiopathy [J ] . Neurology , 2010 , 75 ( 8 ): 693 - 698 .
Singh A , Bonnell G , De Prey J , et al . Small-vessel disease in the brain [J ] . Am Heart J Plus , 2023 , 27 : 100277 .
Karaźniewicz-Łada M , Danielak D , Burchardt P , et al . Clinical pharmacokinetics of clopidogrel and its metabolites in patients with cardiovascular diseases [J ] . Clin Pharmacokinet , 2014 , 53 ( 2 ): 155 - 164 .
Lee CR , Luzum JA , Sangkuhl K , et al . Clinical pharmacogenetics implementation consortium guideline for CYP2C19 genotype and clopidogrel therapy:2022 update [J ] . Clin Pharmacol Ther , 2022 , 112 ( 5 ): 959 - 967 .
Lou NH , Takano T , Pei Y , et al . Purinergic receptor P2RY12-dependent microglial closure of the injured blood-brain barrier [J ] . Proc Natl Acad Sci U S A , 2016 , 113 ( 4 ): 1074 - 1079 .
Pan D , Rong XM , Li HH , et al . Anti-platelet therapy is associated with lower risk of dementia in patients with cerebral small vessel disease [J ] . Front Aging Neurosci , 2022 , 14 : 788407 .
Kherallah RY , Khawaja M , Olson M , et al . Cilostazol:a review of basic mechanisms and clinical uses [J ] . Cardiovasc Drugs Ther , 2022 , 36 ( 4 ): 777 - 792 .
Honda F , Imai H , Ishikawa M , et al . Cilostazol attenuates gray and white matter damage in a rodent model of focal cerebral ischemia [J ] . Stroke , 2006 , 37 ( 1 ): 223 - 228 .
Nishiyama Y , Kimura K , Otsuka T , et al . Dual antiplatelet therapy with cilostazol for secondary prevention in lacunar stroke:subanalysis of the CSPS. com trial [J ] . Stroke , 2023 , 54 ( 3 ): 697 - 705 .
Kim BJ , Kwon SU , Park JH , et al . Cilostazol versus aspirin in ischemic stroke patients with high-risk cerebral hemorrhage:subgroup analysis of the PICASSO trial [J ] . Stroke , 2020 , 51 ( 3 ): 931 - 937 .
Han SW , Song TJ , Bushnell CD , et al . Cilostazol decreases cerebral arterial pulsatility in patients with mild white matter hyperintensities:subgroup analysis from the Effect of Cilostazol in Acute Lacunar Infarction Based on Pulsatility Index of Transcranial Doppler (ECLIPse) study [J ] . Cerebrovasc Dis , 2014 , 38 ( 3 ): 197 - 203 .
McHutchison C , Blair GW , Appleton JP , et al . Cilostazol for secondary prevention of stroke and cognitive decline:systematic review and meta-analysis [J ] . Stroke , 2020 , 51 ( 8 ): 2374 - 2385 .
Park HK , Lee JS , Kim BJ , et al . Cilostazol versus aspirin in ischemic stroke with cerebral microbleeds versus prior intracerebral hemorrhage [J ] . Int J Stroke , 2021 , 16 ( 9 ): 1019 - 1030 .
Kim BC , Youn YC , Jeong JH , et al . Cilostazol versus aspirin on white matter changes in cerebral small vessel disease:a randomized controlled trial [J ] . Stroke , 2022 , 53 ( 3 ): 698 - 709 .
Kitamura A , Manso Y , Duncombe J , et al . Long-term cilostazol treatment reduces gliovascular damage and memory impairment in a mouse model of chronic cerebral hypoperfusion [J ] . Sci Rep , 2017 , 7 ( 1 ): 4299 .
Tai SY , Chien CY , Chang YH , et al . Cilostazol use is associated with reduced risk of dementia:a nationwide cohort study [J ] . Neurotherapeutics , 2017 , 14 ( 3 ): 784 - 791 .
Chien CF , Huang LC , Li KY , et al . Cognitive effects of cilostazol in Alzheimer’s dementia patients with peripheral arterial occlusive disease:a case-control study [J ] . Geriatr Gerontol Int , 2023 , 23 ( 3 ): 194 - 199 .
Yanai , Endo S . PDE3 inhibitors repurposed as treatments for age-related cognitive impairment [J ] . Mol Neurobiol , 2019 , 56 ( 6 ): 4306 - 4316 .
Blair GW , Janssen E , Stringer MS , et al . Effects of cilostazol and isosorbide mononitrate on cerebral hemodynamics in the LACI-1 randomized controlled trial [J ] . Stroke , 2022 , 53 ( 1 ): 29 - 33 .
Wardlaw JM , Woodhouse LJ , Mhlanga II , et al . Isosorbide mononitrate and cilostazol treatment in patients with symptomatic cerebral small vessel disease:the lacunar intervention trial-2(LACI-2) randomized clinical trial [J ] . JAMA Neurol , 2023 , 80 ( 7 ): 682 - 692 .
Das AS , Regenhardt RW , Vernooij MW , et al . Asymptomatic cerebral small vessel disease:insights from population-based studies [J ] . J Stroke , 2019 , 21 ( 2 ): 121 - 138 .
Lam BYK , Cai Y , Akinyemi R , et al . The global burden of cerebral small vessel disease in low- and middle-income countries:a systematic review and meta-analysis [J ] . Int J Stroke , 2023 , 18 ( 1 ): 15 - 27 .
Hannawi Y , Vaishnav A , Coskun EP , et al . Covert cerebral small vessel disease:ready for clinical prime time [J ] . J Am Heart Assoc , 2023 , 12 ( 24 ): e029891 .
Sato H , Koretsune Y , Fukunami M , et al . Aspirin attenuates the incidence of silent brain lesions in patients with nonvalvular atrial fibrillation [J ] . Circ J , 2004 , 68 ( 5 ): 410 - 416 .
Bilski AE , Aparicio HJ , Gutierrez J , et al . Antiplatelet therapy or not for asymptomatic/incidental lacunar infarction [J ] . Stroke , 2023 , 54 ( 7 ): 1954 - 1959 .
Smith EE , Saposnik G , Biessels GJ , et al . Prevention of stroke in patients with silent cerebrovascular disease:a scientific statement for healthcare professionals from the American heart association/American stroke association [J ] . Stroke , 2017 , 48 ( 2 ): 44 - 71 .
Naka H , Nomura E , Kitamura J , et al . Antiplatelet therapy as a risk factor for microbleeds in intracerebral hemorrhage patients:analysis using specific antiplatelet agents [J ] . J Stroke Cerebrovasc Dis , 2013 , 22 ( 6 ): 834 - 840 .
Sakuta K , Yaguchi H , Sato T , et al . The impact of cerebral microbleeds presence on outcome following minor stroke treated with antiplatelet therapy [J ] . Front Neurol , 2020 , 11 : 522 .
Wang M , Yang YY , Wang YJ , et al . Dual antiplatelet therapy in acute ischaemic stroke with or without cerebral microbleeds [J ] . Eur J Neurosci , 2023 , 57 ( 7 ): 1197 - 1207 .
Soo YO , Yang SR , Lam WW , et al . Risk vs benefit of anti-thrombotic therapy in ischaemic stroke patients with cerebral microbleeds [J ] . J Neurol , 2008 , 255 ( 11 ): 1679 - 1686 .
Wardlaw JM , Debette S , Jokinen H , et al . ESO Guideline on covert cerebral small vessel disease [J ] . Eur Stroke J , 2021 , 6 ( 2 ): Ⅳ .
Gdovinova Z , Kremer C , Lorenzano S , et al . Aspirin for primary stroke prevention;evidence for a differential effect in men and women [J ] . Front Neurol , 2022 , 13 : 856239 .
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