摘要
心血管疾病是全球范围内导致死亡的主要原因之一，阿司匹林因其抗炎和抗血小板聚集特性，在其预防中具有重要地位。本研究旨在探讨阿司匹林在心血管疾病一级和二级预防中的临床应用及其作用机制，通过系统回顾相关文献并结合前瞻性队列研究数据，分析不同剂量与使用人群的疗效及安全性。研究发现，低剂量阿司匹林可通过抑制环氧合酶活性减少血栓素A2生成，从而有效降低特定高危人群的心血管事件发生率，但在一般人群中并未显著降低风险且可能增加出血风险。此外，基因多态性对药物反应的影响进一步揭示了个体化用药的重要性。本研究创新性地提出了基于风险分层和遗传背景的精准用药策略，为优化阿司匹林临床应用提供了理论依据，同时强调需综合评估患者获益与潜在风险以实现最佳预防效果。关键词：阿司匹林；心血管疾病；一级和二级预防；精准用药；基因多态性
Clinical Application and Mechanism Research of Aspirin in Cardiovascular Disease Prevention
Abstract
Cardiovascular diseases are among the leading causes of death worldwide, and aspirin plays a significant role in their prevention due to its anti-inflammatory and antiplatelet aggregation properties. This study investigates the clinical application and mechanisms of aspirin in the primary and secondary prevention of cardiovascular diseases by systematically reviewing relevant literature and analyzing data from prospective cohort studies to evaluate the efficacy and safety across different doses and populations. The findings indicate that low-dose aspirin reduces thromboxane A2 production by inhibiting cyclooxygenase activity, effectively lowering the incidence of cardiovascular events in specific high-risk populations. However, in the general population, it does not significantly reduce risk and may increase the likelihood of bleeding. Furthermore, the influence of genetic polymorphisms on drug response highlights the importance of personalized medicine. Innovatively, this study proposes a precision medicine strategy based on risk stratification and genetic background, providing a theoretical basis for optimizing aspirin's clinical application. It also emphasizes the necessity of balancing patient benefits with potential risks to achieve optimal preventive outcomes.
Keywords: Aspirin; Cardiovascular Disease; Primary And Secondary Prevention; Precision Medication; Gene Polymorphism
目录
摘要 I
Abstract II
引言 1
1 阿司匹林的药理特性与作用机制 1
1.1 抗血小板聚集机制研究 1
1.2 炎症调节与心血管保护 2
1.3 药代动力学特征分析 2
2 阿司匹林在心血管疾病预防中的临床证据 3
2.1 一级预防的研究进展 3
2.2 二级预防的疗效评估 3
2.3 特殊人群的应用效果 4
3 阿司匹林使用的安全性与风险评估 4
3.1 出血风险的机制探讨 4
3.2 不良反应的监测与管理 4
3.3 风险获益比的综合评价 5
4 阿司匹林临床应用的优化策略 5
4.1 剂量选择与个体化治疗 5
4.2 联合用药的可行性分析 6
4.3 新型替代药物的比较研究 6
结论 7
参考文献 8
致谢 9
