Клиническая и генетическая характеристика резистентности антитромбоцитарной терапии после ишемического инсульта (литературный обзор)
https://doi.org/10.52420/umj.24.3.139
EDN: OHCAOU
Аннотация
Ежегодно среди всех ишемических инсультов 20 % являются повторными, характеризуются тяжелым течением и высокими показателями летальности и инвалидизации. На предотвращение повторной мозговой катастрофы направлены меры вторичной профилактики, что приводит к уменьшению риска развития повторного острого нарушения мозгового кровообращения на 20–30 %. Одним из направлений терапии является назначение антитромбоцитарных препаратов. В настоящее время в России широко используются ацетилсалициловая кислота и клопидогрел. Эффективное ингибирование тромбоцитов путем назначения этих антиагрегантов является одной из приоритетных задач в лечении атеротромботического ишемического инсульта. При этом у ряда пациентов развивается резистентность к антиагрегантам, что связано со множеством факторов, например, взаимодействием лекарств, наличием сопутствующих заболеваний и генетической предрасположенностью. Для контроля за формированием лабораторной резистентности разработано несколько методов оценки функции тромбоцитов. Например, оптическая агрегатометрия по Борну, тромбоэластограмма, проточная цитометрия. В настоящее время нет «золотого стандарта» для определения высокой остаточной активности тромбоцитов, поскольку у каждого метода есть преимущества и недостатки. В работе рассмотрены методы выявления лабораторной резистентности и факторы, влияющие на ее развитие, в зависимости от назначенного антитромбоцитарного препарата.
Об авторах
Т. Ю. Батенькова
Свердловская областная клиническая больница № 1
Россия
Конфликт интересов:
Россия
Батенькова Татьяна Юрьевна — невролог неврологического отделения, консультативно-диагностическая поликлиника.
Екатеринбург
Конфликт интересов:
Нет
Л. И. Волкова
Свердловская областная клиническая больница № 1; Уральский государственный медицинский университет
Россия
Конфликт интересов:
Россия
Волкова Лариса Ивановна — доктор медицинских наук, профессор, профессор кафедры неврологии и нейрохирургии, институт клинической медицины, УГМУ; невролог, научный руководитель неврологической клиники, Свердловская ОКБ № 1.
Екатеринбург
Конфликт интересов:
Нет
Е. В. Кудрявцева
Клинико-диагностический центр «Охрана здоровья матери и ребенка»; Уральский институт управления здравоохранением имени А.Б. Блохина
Россия
Конфликт интересов:
Россия
Кудрявцева Елена Владимировна — доктор медицинских наук, доцент, генетик отделения медико-генетического консультирования, КДЦ «Охрана здоровья матери и ребенка»; профессор кафедры акушерства и гинекологии, Уральский институт управления здравоохранением им. А.Б. Блохина.
Екатеринбург
Конфликт интересов:
Нет
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Рецензия
Для цитирования:
Батенькова ТЮ, Волкова ЛИ, Кудрявцева ЕВ. Клиническая и генетическая характеристика резистентности антитромбоцитарной терапии после ишемического инсульта (литературный обзор). Уральский медицинский журнал. 2025;24(3):139–156. https://doi.org/10.52420/umj.24.3.139. EDN: OHCAOU
For citation:
Batenkova TY, Volkova LI, Kudryavtseva EV. Clinical and Genetic Characteristics of Antiplatelet Therapy Resistance After Ischemic Stroke (Literature Review). Ural Medical Journal. 2025;24(3):139–156. (In Russ.) https://doi.org/10.52420/umj.24.3.139. EDN: OHCAOU
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