新型口服抗凝药在脑血管病领域应用的研究进展

Advances in the application of non-Vitamin K antagonist anticoagulants in cerebrovascular diseases

新型口服抗凝药又称直接口服抗凝药,与传统口服抗凝药华法林相比,起效快,半衰期短,与食物、药物相互作用小,无需频繁监测凝血指标。对于心房颤动相关卒中的预防,新型口服抗凝药抗凝效果不劣于华法林,出血(尤其是颅内出血)风险低,安全性更高,成为目前抗凝领域研究的热点。在隐源性卒中、颈部动脉夹层、脑静脉系统血栓形成、进展性卒中和高危非致残性卒中等脑血管病的治疗过程中,尽管支持应用抗凝的证据强弱不等,但是鉴于新型口服抗凝药拥有更高的安全性,相关探索性研究不断出现。该文对近年来新型口服抗凝药在脑血管病领域中应用的相关研究展开阐述,探讨其未来的研究热点和方向。

Compared with traditional oral anticoagulant of warfarin,the non-Vitamin K antagonist oral anticoagulants(NOACs),also known as direct oral anticoagulants,have the advantages of rapid onset,short half-life,less interaction with food and drugs,and no need for frequent monitoring of coagulation index.Large-scale clinical trials have confirmed that its anticoagulant effect in the prevention of atrial fibrillation-related stroke was not inferior to warfarin.As it has lower risk of bleeding(especially intracranial hemorrhage)and higher safety,NOACs have become a hot research topic in the field of anticoagulation.In the treatment of cerebrovascular diseases,such as cryptogenic stroke,carotid artery dissection,cerebral venous thrombosis,progressive stroke,and high-risk non-disabled stroke,although the evidence supporting the application of anticoagulation varies in strength,in view of the higher safety of new oral anticoagulants,relevant exploratory studies are constantly emerging.This article reviewed the recent advances in the use of NOACs for cerebrovascular diseases and discussed its research hotspots and future directions.