阿司匹林联合P2Y 12受体抑制剂（氯吡格雷、普拉格雷或替格瑞洛）的双联抗血小板治疗是急性冠状动脉综合征的基础治疗。与氯吡格雷相比，普拉格雷和替格瑞洛在缺血获益方面更有优势，但前者增加出血风险，后者对患者依从性有更高要求。现总结不同临床情况下P2Y 12受体抑制剂的选择、治疗时机和疗程方面的临床证据和相关指南，为临床提供参考。患者停用双联抗血小板治疗的原因影响临床预后，降低出血风险、加强医患沟通可提高患者依从性。“,”For acute coronary syndrome,a dual antiplatelet therapy comprised of treatment with aspirin and either P2Y 12 inhibitors, clopidogrel,prasugrel,or ticagrelor is usually employed.New oral P2Y 12 inhibitors appear to be more effective for reducing ischemic events, but there is a obvious increased risk in major bleeding with prasugrel,or bad compliance because of the need for twice daily administration with ticagrelor.We focus on the updates of P2Y 12 inhibitor selection,administration timing and optimal duration in the clinical practice.Car-diac events after dual antiplatelet therapy cessation depend on the reason underlying.Interventions to increase adherence should focus on re-ducing bleeding risk and communication between patients and physicians.