阿司匹林与铝镁匹林在冠心病抗血小板治疗中的研究进展

Research Progress of Aspirin and Aluminum Magnesium Aspirin in Antiplatelet Therapy of Coronary Heart Disease

摘要: 阿司匹林与铝镁匹林作为冠心病抗血小板治疗的基石药物，其机制均通过抑制环氧合酶-1发挥抗栓作用。铝镁匹林通过复方缓冲设计减轻胃黏膜刺激，但临床研究显示其胃肠道保护效果在整体人群中与阿司匹林无显著差异，两种药物在抑制血小板聚集、预防心血管事件及联合P2Y12抑制剂的疗效上表现等效；安全性方面，阿司匹林的长期肾代谢负担与铝镁匹林的潜在铝蓄积风险需警惕，但现有证据尚未明确相关临床结局差异。未来需聚焦高危人群分层、长期安全性评估及个体化治疗策略，以优化冠心病抗血小板管理的精准性。

Abstract: Aspirin and Al-Mg-aspirin, as cornerstones of antiplatelet therapy for coronary heart disease, both play an antithrombotic role by inhibiting cyclooxygenase-1. Al-Mg-aspirin reduces gastric mucosal irritation through compound buffer design, but clinical studies show that its gastrointestinal protective effect is not significantly different from that of aspirin in the whole population, and the two drugs are equivalent in inhibiting platelet aggregation, preventing cardiovascular events and combining P2Y12 inhibitors. In terms of safety, the long-term renal metabolic burden of aspirin and the potential aluminum accumulation risk of aluminum magnesium aspirin need to be vigilant, but the existing evidence has not yet clarified the difference in clinical outcomes. In the future, it is necessary to focus on stratification, long-term safety assessment and individualized treatment strategies of high-risk groups in order to optimize the accuracy of antiplatelet management of coronary heart disease.