非透析慢性肾脏病患者静脉血栓栓塞症形成机制及抗凝治疗进展

Recent advances in mechanism and anticoagulant therapy of venous thromboembolism in patients with non-dialysis chronic kidney disease

慢性肾脏病患者有较高的血栓栓塞风险,脑梗死、心肌梗塞等致死性血栓并发症的发生率逐年上升,这可能与慢性肾脏病特有的尿毒症毒素蓄积、凝血功能障碍、血小板活化以及止血障碍等因素有关,而对于慢性肾脏病患者而言,抗血小板及抗凝治疗则需根据肾小球滤过率调整剂量及用药种类。所以,本文将对于非透析慢性肾脏病患者的血栓栓塞并发症发生机制和抗凝治疗方法、进展进行综述。

Chronic kidney disease(CKD)patients are at an elevated risk of thromboembolism,cerebral infarction and myocardial infarction.The incidence of fatal thrombotic complications has been rising over the years.It may be attributed to uremic toxin accumulation,blood coagulation dysfunction,platelet activation and abnormal hemostasis associated with CKD.Therefore dose adjustments and drug selections for antiplatelet and anticoagulant therapy should be based upon the level of glomerular filtration rate(GFR).This review summarized the underlying mechanisms of thromboembolic complications and recent advances of anticoagulant therapy for non-dialysis CKD patients.