新型口服抗凝药物在冠状动脉粥样硬化性心脏病治疗中的临床研究进展

Research progress in the treatment of coronary atherosclerotic heart disease with new oral anticoagulants

维生素K拮抗剂是冠状动脉粥样硬化性心脏病患者,尤其是急性冠状动脉综合征患者抗凝治疗应用中最主要的药物,但其管理较困难,需要定期监测国际标准化比值范围,出血风险较高,给临床应用带来了一定的困扰。而新型口服抗凝药(new oral anticoagulants,NOAC)通过针对单个有活性的凝血因子(Ⅹa因子或Ⅱa因子)发挥抗凝作用,不依赖于抗凝血酶,可以固定剂量给药而无需常规凝血监测,出血风险小,同时临床研究也证实其用于冠状动脉粥样硬化性心脏病患者抗凝治疗效果可靠,目前临床应用NOAC替代维生素K拮抗剂抗凝治疗越来越多。本文就其在冠心病治疗中的相关临床研究进展进行综述。

Vitamin K antagonist is the most important drug for anticoagulant therapy in patients with coronary atherosclerotic heart disease,especially in patients with acute coronary syndrome.However,its management is difficult.It is necessary to regularly monitor the international normalized ratio range and the risk of bleeding is high,brings some trouble to clinical treatment.The new oral anticoagulants(NOAC)exert anticoagulant effects against a single active coagulation factor(factorⅩa orⅡa),independent of antithrombin,and can be administered at a fixed dose without conventional coagulation monitoring,the risk of bleeding is small,and clinical research has also confirmed that it was reliable for anticoagulant therapy in patients with coronary atherosclerotic heart disease.At present,the clinical application of NOAC instead of vitamin K antagonists in anticoagulation treatment is increasing.This article reviewed its related progress in the treatment of coronary atherosclerotic heart disease.