缺血性脑血管疾病(ischemic cerebrovascular disease, ICVD)中一般短暂性脑缺血发作(transient ischemic attack, TIA)和缺血性脑卒中(ischemic stroke, IS)多发,抗血小板治疗是ICVD急性期和二级预防最重要的环节,部分ICVD患者服用氯吡格雷抗血小板过程中存在氯吡格雷耐药。本文就ICVD患者氯吡格雷耐药(clopidogrel resistance, CR)、基因多态性、前瞻性研究及基因检测意义、氯吡格雷抵抗患者抗血小板治疗方案作一综述,以期在临床中为缺血性脑血管疾病病人提供更为科学化、个体化的治疗。Transient ischemic attack and ischemic stroke are common in ischemic cerebrovascular diseases, and antiplatelet therapy is the most important link in the acute phase and secondary prevention of ICVD. Some patients with ICVD have clopidogrel resistance during taking clopidogrel antiplatelet. This article reviews the clopidogrel resistance, gene polymorphism and the significance of genetic testing, prospective study and antiplatelet therapy for patients with clopidogrel resistance in ICVD, in order to provide more scientific and individualized treatment for patients with ischemic cerebrovascular disease in clinic.
