老年患者抗凝药物使用进展

Progress in the Use of Anticoagulant Drugs in Elderly Patients

随着社会老龄化越来越明显,65岁以上老年人口越来越多,而老年患者常常合并房颤、深静脉血栓或其他心血管疾病,这些疾病都需要长期口服抗凝药。抗凝药物的使用率虽越来越高,但仍有许多患者因为害怕出血而导致抗凝不足,从而增加了致死性卒中的发生率。本文拟从老年人凝血功能、抗凝药物的种类及其特点、与其他药物之间的相互作用展开,从一些老年常见疾病的抗凝药使用情况出发,讨论老年患者抗凝药物的选择和剂量使用,并提出口服小剂量抗凝药物的安全性和可行性,为临床医师个性化地为老年患者选择合适种类和剂量的抗凝药物提供依据。

As society is becoming more and more aging, there is an increasing number of elderly people over 65 years old, and elderly patients often have atrial fibrillation, deep vein thrombosis, or other cardiovascular diseases, all of which require long-term oral anticoagulants. Although the use rate of anticoagulant drugs is increasing, there are still many patients who are afraid of bleeding and lead to insufficient anticoagulation, which increases the incidence of fatal stroke. This article intends to start from the coagulation function of the elderly, the types and characteristics of anticoagulant drugs, and the interaction with other drugs. It will review the use of anticoagulants for some common diseases in the elderly, and discuss the selection of anticoagulant drugs for elderly patients, which dosage is used, and the safety and feasibility of oral small-dose anticoagulant drugs are proposed, which provides a basis for clinicians to personally select appropriate types and dosages of anticoagulant drugs for elderly patients.