替格瑞洛：新型的抗血小板药物-1.pptVIP

PLEASE NOTE THAT USE OF THESE MATERIALS IS SUBJECT TO LOCAL APPROVAL AND MUST BE “SIGNED OFF” BY YOUR LOCAL NOMINATED SIGNATORY These slides are dated November 2010 with information known to AstraZeneca Medical Affairs at that time; they will be amended when new information and/or label approvals occur * 中国1/5是慢代谢，国外2－3％。所以中国人比白种人代谢低，所需剂量 多项国内外指南均已在抗血小板治疗中对替格瑞洛做出了推荐。 在中国，PCI指南和NSTE-ACS指南在倍林达中国上市之前即已作出推荐。 * Platelets play a key role in the development of thrombus, which happens via a 3-step process: adhesion, activation, and aggregation[Vorchheimer 2006:A,B,C] Thrombosis involves interactions among the endothelium, the plaque, and the blood platelets[Brogan 2002:A] When the endothelium over a plaque becomes eroded or the plaque ruptures, the subendothelium, which is highly thrombogenic, is exposed to arterial blood flow[Brogan 2002:A] In the case of plaque rupture, the lipid core of the plaque also has thrombotic properties; a thrombus forms over the plaque when activated platelets adhere to the exposed subendothelium[Brogan 2002:A] Vorchheimer DA, et al. Mayo Clin Proc. 2006;81:59-68. Brogan GX. Acad Emerg Med. 2002;9:1029-1044. This slide shows platelet shape function relationships in thrombogenesis under physiological blood flow The ball shape allows platelet rolling on a thrombogenic surface, and the filopods may support this rolling, which is important for the activation of integrin ?IIβ3 and firm adhesion[Kuwahara 2002:B] The hemispherical change resulting in an increase of the area adjacent to the surface seems to allow for firm adhesion. However, at this time, platelet adhesion is still reversible[Kuwahara 2002:B] Finally, the extensive spreading of the platelet ensures firm adhesion that is irreversible. This is required in generating a greater thrombogenic base that allows the capture of adhesive proteins and platelets in a flow, leading to platelet aggregate accumulation on the surface[Kuwahara 2002:B] Kuwahara M, et al. Arterioscler Thr