新型口服抗凝药在心房颤动卒中预防中的研究进展

Current Research of New Oral Anticoagulants in Stroke Prevention of Atrial Fibrillation

心房颤动是卒中的独立危险因素,口服抗凝药是预防心房颤动卒中最有效的药物治疗手段。华法林作为近年来心房颤动抗凝治疗的基石一直未被完全取代,却因其治疗上存在的众多限制导致其应用率低或使用不达标等,为解决华法林的这一不足,新型口服抗凝药应运而生,并以其剂量固定、无需常规监测凝血、药物食物相互作用少、出血风险小等优点逐渐受到临床青睐,然而其不足也不容忽视,尚需更多确切的临床实验研究来明确其在临床上的合理应用。现拟通过新型口服抗凝药的抗凝机制、药理学特点及最新试验研究做一简单介绍及比较,并对临床合理选用抗凝药做一简要总结及展望,望能为临床医生针对心房颤动患者合理选用新型口服抗凝药提供帮助。

Atrial fibrillation is an independent risk factor for stroke.Oral anticoagulation is the most effective medical treatment for preventing stroke.Warfarin has been the cornerstone of anticoagulative treatment of atrial fibrillation in recent years,and has not been totally replaced.However,as many restrictions exist in its treatment,which can result in low application rate,substandard use and even risk of increased risk of bleeding.In order to solve these problems,new oral anticoagulants （NOACs） have emerged.With advantages such as fixed dosage,no need to routinely monitor coagulation,little interaction of drug and food and small risk of blooding,it has become popular in clinical application.However,its disadvantages should not be ignored.There still needs to be further clinical studies to identify its clinical application.In this paper,through brief introduction and comparison of mechanism of NOACs,pharmacokinetic features,latest study experiments and status quo of clinical application,briefly summarizes how to select anticoagulant drugs in clinical application and prospected future usage.Thereby offering to help clinical doctors to select anticoagulant drugs for patients of atrial fibrillation,and provide ideas and direction for further study.