急性缺血性脑卒中是最常见的脑卒中类型，约占全部脑卒中的60%～80%。急性缺血性脑卒中的管理强调早期诊断、早期治疗、早期康复和早期预防复发。在循证医学原则指导下，国内外脑卒中组织制定了不同国家的脑血管病防治指南。中华医学会神经病学分会脑血管病学组自2002 年开始修订《中国急性缺血性脑卒中诊治指南》，并且强调了抗栓治疗的重要性。随着脑卒中防治工作的深入开展、医疗技术的进步以及对缺血性脑卒中血栓形成机制及抗血小板精准治疗的认识不断提高，提出了抗栓精准治疗策略。本文对急性缺血性脑卒中血栓形成机制及抗栓治疗策略的最新进展进行综述，旨在为临床防治急性缺血性脑卒中提供参考。

Acute ischemic stroke is the most common type of stroke, accounting for 60%-80% of all strokes. The management of acute ischemic stroke emphasizes early diagnosis, early treatment, early rehabilitation and early prevention of recurrence. Under the guidance of the principles of evidence-based medicine, stroke organizations at home and abroad have developed guidelines for the prevention and treatment of cerebrovascular diseases in different countries. Cerebrovascular Disease Group of the Neurology Branch of the Chinese Medical Association has revised the guidelines for the prevention and treatment of acute ischemic stroke in China since 2002 and stressed the importance of antithrombotic therapy. With the deepening of stroke prevention and treatment and the development of medical technology, the understanding of the mechanism of ischemic stroke thrombosis and accurate antiplatelet therapy is increasing, which provides a new opportunity for accurate antithrombotic therapy. In this paper, the form of thrombosis and the latest progress in antithrombotic therapy in acute ischemic stroke are reviewed, which provide therapeutic references for clinical prevention and treatment of acute ischemic stroke.