抗凝药物在肝肾功能不全患者中的临床应用进展

Clinical application progress of anticoagulants in patients with hepatic and/or renal dysfunctions

肝肾功能不全病理生理状态对各种抗凝药物在患者体内的代谢和排泄都会产生一定的影响,使抗凝药物在患者体内的暴露增加,肾脏清除率降低和半衰期延长,从而导致抗凝效果增强,出血风险增加。临床上在肝肾功能不全的患者中使用抗凝药物应当密切监测相关指标,根据患者具体情况调整使用剂量,进行个体化用药,降低患者出血风险。

Hepatic and/or renal dysfunction has impact on metabolism and excretion of anticoagulants,such as increasing the exposure in patients,decreasing the renal clearance and prolonging the half-life,which result in the increase of anticoagulant effect and the risk of hemorrhage.Efforts should be made to monitor relevant indexes of anticoagulant treatment for patients with hepatic and/or renal dysfunction closely.According to individual situations of the patients,drugs can be individualized by adjusting dosage and reducing the risk of hemorrhage.