新型口服抗凝药预防心房颤动患者的缺血性卒中

New oral anticoagulants for preventing ischemic stroke in patients with atrial fibrillation

新型口服抗凝药包括直接凝血酶抑制剂和因子Xa抑制药，它们克服了华法林的多个缺点，在非瓣膜性心房颤动患者中预防卒中和体循环栓塞的疗效优于或不逊于华法林，且降低了出血（尤其是颅内出血）风险。然而，目前尚无高效逆转其抗凝作用的药物。文章对目前常用的新型口服抗凝药的药理学特点、临床疗效、并发症及其处理等进行了综述。

New oral anticoagulants, including direct thrombin inh^itors and factor X a inhibitors. They have overcome several shortcomings of warfarin. The efficacy of preventing stroke and systemic embolism is superior to or not inferior to warfarin in patients with non-valvular atrial fibrillation, and they can decrease the risk of bleeding （especially intracranial hemorrhage）. However, no agent can efficiently reverse its anticoagulant effect now. This article reviews the pharmacological characteristics, clinical efficacy, complications, and its management of the commonly used new oral anticoagulants at present.