新型抗凝药Ⅺ因子抑制剂监测方法及逆转策略研究进展

Advances in Monitoring and Reversal Strategies for the Novel Anticoagulants FactorⅪInhibitors

Ⅺ因子(FⅪ)在血栓形成中扮演关键角色,而在止血过程中的作用较为有限。这种作用差异为预防和治疗血栓性疾病开辟了新的途径,即靶向FⅪ可能是一种更为安全的抗凝策略。目前,越来越多的FⅪ抑制剂进入Ⅲ期临床试验,尽管这些抑制剂展现出巨大的临床潜力,但其监测和逆转策略尚未明确,这给实验室监测和临床实践带来了新的挑战。本文在FⅪ的生理功能和FⅪ抑制剂在研药物的基础上,系统地探讨了FⅪ抑制剂的实验室检测抗凝活性证据,结合遗传性Ⅺ因子缺乏患者的治疗方案总结了FⅪ抑制剂的逆转方法,为制订临床治疗方案及逆转策略提供一定的参考。

FactorⅪ(FⅪ)plays a major role in thrombus amplification and an ancillary role in hemostasis.This differential contribution is expected to provide new ideas for the prevention and treatment of thrombotic diseases by targeting FⅪas a potentially safer anticoagulation strategy.Currently,an increasing number of FⅪinhibitors are entering phaseⅢclinical trials,and although these inhibitors showed promising clinical potential,the strategies for monitoring and reversing the effects of these inhibitors remain unclear,which poses new challenges for laboratory monitoring and clinical practice.This review,based on the physiological function of FⅪand FⅪinhibitors under study,systematically explored the laboratory evidence of coagulation activity linked to these inhibitors,summarized potential methods of reversal in combination with the treatment protocols of inherited FⅪdeficiency,which provided certain references for the development of clinical treatment protocols and reversal strategies.