纵览新型口服抗凝药物

Embracing novel oral anticoagulant drugs

第三代新型口服抗凝药物(NOAC)的代表Ⅹa因子抑制剂(利伐沙班)和Ⅱa因子抑制剂(达比加群)在中国临床应用已有多年。与第一代抗凝药物大分子肝素和第二代低分子肝素相比, NOAC作为单靶点和直接的凝血因子抑制剂, 在有效抗凝和减少并发症发生方面具有明显优势。但是NOAC完美吗?回答是否定的。NOAC在临床应用中还是存在一些不确定性和挑战, 本文就相应问题进行论述。

Factor Xa inhibitors Rivaroxaban and factor IIa inhibitor Dabigatran,representative of the third-generation of novel oral anticoagulants(NOACs),have been used clinically in China for many years.Compared to first-generation high molecular weight heparin and second-generation low molecular weight heparin,as a single-target,direct blood coagulation factor inhibitor has obvious advantages in effective anticoagulation and reducing adverse complications.However,are NOACs perfect?The answer is no.There are still some uncertainties and challenges in the clinical application of NOACs.This paper discusses the corresponding problems as follows.