利伐沙班血药浓度监测的研究进展

Research progress in plasma concentration monitoring of rivaroxaban

利伐沙班是目前临床上广泛使用的新型口服抗凝药,具有可预测的药代动力学和药效学特征,药物-药物和食物-药物相互作用较少,常以固定剂量给药,无需常规监测凝血参数。但在某些紧急临床情况下,如出血、急性脑卒中、急性肾损伤、紧急手术前和怀疑药物蓄积中毒等,有必要监测患者体内利伐沙班血药浓度。现有研究表明,利伐沙班血药浓度范围广泛,个体差异性大,存在临床用药风险。监测利伐沙班血药浓度,探索其药物治疗窗,可辅助临床个体化用药和安全用药。本文旨在概述利伐沙班血药浓度的影响因素、监测方法、治疗窗研究进展及相关病例报道,以期为临床上利伐沙班合理用药提供参考。

Rivaroxaban,a novel oral anticoagulant drug,is widely prescribed in clinical practice.Rivaroxaban offers predictable pharmacokinetic and pharmacodynamic properties,a lowprobability of drug-drug and food-drug interactions.Compared with warfarin,rivaroxaban does not require continuous therapeutic monitoring and can be administered in fixed doses.However,in certain emergency clinical situations,such as bleeding,acute stroke,acute kidney injury,prior to urgent surgery and in the suspected accumulation of durg,plasma concentration monitoring of rivaroxaban is necessary and important for patients.Existing studies proved that there were significant individual variability and wide range in the plasma rivaroxaban concentration,which increased the risk of clinical use.Therefore,Data in the degree of rivaroxaban concentration may provide recommendations for the clinical application to promote medication safety and individuality in the future.This article collected the latest literatures and case reports related to research progress of rivaroxaban plasma concentration monitoring,and Summarized influencing factors,monitoring methods,so as to provide a basis for further study on rational use of rivaroxaban in clinical.