中风与神经疾病杂志2026，Vol.43Issue(3)：204-213,10.DOI:10.19845/j.cnki.zfysjjbzz.2026.0036
急性缺血性脑卒中抗栓治疗的药物相互作用机制与临床挑战
Drug-drug interaction mechanisms and clinical challenges in antithrombotic therapy for acute ischemic stroke
摘要
Abstract
Objective To systematically summarize the pharmacological characteristics and clinical applications of antithrombotic medications in ischemic stroke,as well as their interactions with drugs used for common comorbidities,and to provide a reference for clinical medication.Methods Based on the UpToDate database and the integration with pharmacoki-netic and pharmacodynamic mechanisms,this study systematically analyzed interactions between antithrombotic agents and between antithrombotics and drugs for comorbid conditions.Interactions were categorized and evaluated based on the level of evidence.Results The distinct pharmacological mechanisms of different antithrombotic drugs determine their patterns of drug-drug interactions.Combination antithrombotic therapy produces synergistic antithrombotic effects but increases the risk of hemorrhage.Extensive interactions exist when antithrombotics are co-administered with medications for cardiovascular dis-eases,metabolic disorders,neuropsychiatric conditions,and infectious diseases.These interactions primarily involve the cy-tochrome P450 enzyme system and P-glycoprotein pathways,which may compromise therapeutic efficacy or elevate the risk of bleeding and thrombosis.Conclusion Multiple drug interactions are present in antithrombotic therapy for ischemic stroke.In clinical practice,it is essential to consider the impact of pharmacokinetic and pharmacodynamic mechanisms.By integrat-ing tools such as pharmacogenomics and therapeutic drug monitoring,individualized medication strategies should be imple-mented to achieve an optimal balance between antithrombotic efficacy and safety.关键词
缺血性脑卒中/抗栓药物/药物-药物相互作用/UpToDateKey words
Ischemic stroke/Antithrombotic drug/Drug-drug interaction/UpToDate引用本文复制引用
寇为民,华星,何昊洋,王亚楠,刘鸣,吴思缈..急性缺血性脑卒中抗栓治疗的药物相互作用机制与临床挑战[J].中风与神经疾病杂志,2026,43(3):204-213,10.基金项目
成都市科技局项目(2024-YF05-00525-SN) （2024-YF05-00525-SN）
四川大学华西医院学科卓越发展1·3·5工程临床研究基金(2024HXFH022) （2024HXFH022）
四川大学华西医院专职博士后研发基金(2024HXBH139) （2024HXBH139）
