抗栓药物引起消化道出血后药物重启时机的研究进展

Research progress on the timing of drug restart after gastrointestinal bleeding caused by antithrombotic drugs

抗栓药物在心脑血管疾病的预防及治疗中发挥重要作用,但由于其会导致患者出现消化道损伤,甚至引起致死性的消化道出血,所以其用药一直受到诸多限制。在抗栓治疗的患者出现消化道出血后,临床医师多会酌情停用抗栓药物,并积极进行镜下或药物止血。但患者停服抗栓药物后会显著增加心脑血管事件和死亡的风险。因此,继续服用抗栓药物预防心脑血管事件势在必行,但消化道出血后重启抗栓药物的最佳时机尚不明确,如何安全有效地重新启用抗血栓药物,使患者最大程度地从抗栓药物中获益已成为临床上一个重要课题,本文就抗栓药物引起消化道出血后的重启时机作一简要综述。

Antithrombotic drugs play an important role in the prevention and treatment of cardiovascular and cerebrovascular diseases.However,it is restricted to use drugs for many conditions,because they can lead to gastrointestinal injury,even fatal gastrointestinal bleeding.After gastrointestinal bleeding occurs in patients treated with antithrombotic therapy,clinicians will appropriately stop using antithrombotic drugs and actively stop bleeding under the endoscopy or drugs.Although,patients who stop taking antithrombotic drugs will significantly increase the risk of cardiovascular and cerebrovascular events and death.Therefore,it is imperative to continue to take antithrombotic drugs to prevent cardiovascular and cerebrovascular events.Nevertheless,the best time to restart antithrombotic drugs after gastrointestinal bleeding is still unclear.How to safely and effectively restart the use of antithrombotic drugs to maximize the benefit of patients from antithrombotic drugs has became an important clinical topic.This article reviewed the timing of reboot after antithrombotic gastrointestinal bleeding.