新型口服抗凝药物适应证及指南推荐意见

Indications and Guidelines Recommendations of New Oral Anticoagulants

新型口服抗凝药物(NOACs)包括直接凝血酶抑制剂(如希美加群、达比加群酯)和直接Ⅹa因子抑制剂(如利伐沙班、阿哌沙班、依度沙班、贝曲沙班)。与传统口服抗凝药物华法林相比,NOACs具有抗凝效果稳定、起效迅速、治疗窗宽、剂量固定、服用方便、生物利用度高、受药物和食物影响小、药代动力学确切、不需定期监测国际标准化比值、个体差异小、颅内出血并发症发生风险低等优势,因此近年来其在最新抗凝指南中的地位逐渐上升。本文主要归纳、总结了NOACs的适应证及指南推荐意见,旨在为NOACs的合理选用提供参考。

New oral anticoagulants(NOACs)include direct thrombin inhibitors(such as ximelagatran and dabigatran etexilate)and direct factorⅩa inhibitors(such as rivaroxaban,apixaban,edoxaban and betrixaban).Compared with traditional oral anticoagulant warfarin,NOACs have many advantages,including stable anticoagulant effect,rapid onset of action,wide therapeutic window,fixed dosage,convenient administration,high bioavailability,less affected by drugs and food,exact pharmacokinetics,nonobligatory of regularly monitoring of international standardization ratios,small individual difference and low risk of intracranial hemorrhagic complications,thus the status of NOACs gradually increased in the latest anticoagulation guidelines in recent years.This paper mainly concluded and summarized the indications and guidelines recommendations of NOACs,to provide a reference for rational selection and use of NOACs.