新型抗凝药物在心脑血管疾病中的临床评价

New oral anticoagulants in cardiovascular and cerebrovascular diseases

心房颤动是缺血性脑卒中的重要独立危险因素,抗凝治疗是预防非瓣膜性心房颤动(NVAF)患者缺血性卒中的有效方法。传统抗凝药物华法林疗效肯定但使用不便。直接凝血酶抑制剂及Ⅹa因子抑制剂干扰凝血过程,抗凝作用肯定,具有剂量固定、无需监测凝血指标的优点,受到临床重视。本文对此类新型抗凝药物的药理作用、药代动力学及临床评价等做一综述。

Patients with atrial fibrillation（AF） are at high risk of ischemic stroke.The use of anticoagulation is highly effective for stroke prevention in patients with nonvalvular atrial fibrillation（NVAF）.The use of warfarin is limited by frequent coagulation monitoring and dose adjustments.A direct thrombin inhibitor and a direct factor Xa inhibitor may provide more consistent and predictable anticoagulation.In this article,the pharmacological effects,pharmacokinetics and clinical evaluation of such new anticoagulants were reviewed.