摘要
心房颤动(简称“房颤”)是临床常见的心律失常之一,其患病率随年龄增长而明显升高。以缺血性脑卒中为代表的血栓栓塞事件是房颤的主要并发症,也是房颤患者致死及致残的重要原因。抗凝治疗是药物预防房颤所致心源性卒中的唯一推荐方案,口服抗凝药物包括维生素K拮抗剂(vitamin K antagonist, VKA)以及新型口服抗凝药(novel oral anticoagulants, NOACs)。综合评估血栓栓塞和出血风险,以及在VKA和NOACs的选择上坚持个体化并兼顾患者的社会经济负担,仍是临床考虑的重点。近年来多项研究表明NOACs在疗效、安全性、治疗依从性方面均较VKA有显著优势。本研究归纳总结不同类型抗凝药物在房颤及其伴随常见合并症时的应用推荐,以期对临床实现个体化抗凝治疗提供选择参考。
Atrial fibrillation is one of the common clinical arrhythmias, and its prevalence increases significantly with age. Thromboembolic event, represented by ischemic stroke, is the major complication of atrial fibrillation, and is also the main cause of death and disability in patients with atrial fibrillation. Anticoagulant therapy is the only recommended regimen for the prevention of cardiogenic stroke caused by atrial fibrillation. Oral anticoagulants include vitamin K antagonist(VKA) and novel oral anticoagulants(NOACs). Comprehensive assessment of thromboembolism and bleeding risks, and adherence to individualization in the selection of VKAs and NOACs while taking into account the socioeconomic burden of patients are still the focus of clinical considerations.In recent years, many studies have shown that NOACs have significant advantages over VKA in terms of efficacy, safety, and compliance. This study summarizes the application recommendations of different types of anticoagulant in the treatment of atrial fibrillation and its associated common comorbidities, so as to provide reference for clinical realization of personalized anticoagulant therapy.
作者
徐燕
沈琦博
XU Yan;SHEN Qibo(Department of Cardiovascular Medicine,Qidong People′s Hospital,Jiangsu Nantong 226200,China;Echocardiography Room,Changzhou Hospital of Traditional Chinese Medicine,Jiangsu Changzhou 213000,China)
出处
《中国医药导刊》
2022年第12期1179-1183,共5页
Chinese Journal of Medicinal Guide
基金
南通市市级科技计划(指导性)项目(项目编号:MSZ20105,项目名称:基于群医学理念的房颤个体化诊疗模式及疗效比较研究)。
关键词
心房颤动
抗凝治疗
缺血性脑卒中
血栓栓塞
研究进展
Atrial fibrillation
Anticoagulant therapy
Ischemic stroke
Thromboembolism
Research progress
