肝硬化合并房颤的抗凝治疗进展

Advances in anticoagulant therapy for cirrhosis combined with atrial fibrillation

近年来相关研究显示,在肝硬化患者中,房颤的发生率明显增高,心房颤动是慢性、长期抗凝治疗最常见的适应证,抗凝治疗对降低缺血性卒中的发生有明确作用。肝硬化合并房颤患者抗凝治疗时,由于肝硬化凝血功能障碍,其出血及栓塞风险明显增高。同时此类患者在使用目前批准的抗凝药物时,均会经肝脏不同程度地代谢与消除。使得抗凝治疗更加复杂。现对肝硬化合并房颤患者抗凝治疗风险与获益的临床研究进行总结,以期为此类患者抗凝治疗提供参考。

Relevant research in recent years has demonstrated that the atrial fibrillation occurrence rate is significantly higher in patients with cirrhosis.The most common indication for long-term anticoagulant therapy is chronic atrial fibrillation.The use of anticoagulant therapy greatly reduces the incidence rate of ischemic stroke.Patients with cirrhosis combined with atrial fibrillation have an elevated risk of bleeding and embolism during anticoagulant therapy due to cirrhotic coagulopathy.At the same time,the liver of such patients will go through varying levels of metabolism and elimination while consuming currently approved anticoagulant drugs,thereby increasing the complexity of anticoagulant therapy.This article summarizes the clinical studies on the risks and benefits of anticoagulant therapy in order to provide a reference for patients with cirrhosis combined with atrial fibrillation.