新型口服抗凝药预防心房颤动患者的缺血性卒中NewOral.PDFVIP

新型口服抗凝药预防心房颤动患者的缺血性卒中 1 2 陈淑英 ，彭 英 （1．汕头大学医学院第一附属医院，广东汕头 515000；2 ．中山大学 孙逸仙纪念医院，广东广州 510000 ） 摘要: 抗凝治疗是预防心房颤动患者发生缺血性卒中的重要措施。但传统口服抗凝药华法林存在诸多缺点，临床 抗凝治疗率低。新型口服抗凝药主要包括直接凝血酶抑制剂和Xa 因子抑制剂，他们克服了华法林的多个缺点， 在非瓣膜性心房颤动患者中预防卒中和体循环栓塞的疗效优于或不逊于华法林，且降低了出血（尤其是颅内出血） 风险。然而，目前尚无高效逆转其抗凝作用的药物。本文对目前常用的新型口服抗凝药的药理特点、临床疗效、 并发症及其处理等进行综述。 关键词：神经病学；抗凝药；脑卒中；凝血酶；Xa 因子 New Oral Anticoagulants for Stroke Prevention in Patients with Atrial Fibrillation 1 2 CHEN Shuying , PENG Ying (1. The First Affiliated Hospital of Shantou University Medical College, Shantou, 515000, China ；2. Sun Yat-sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510000, China) Abstract: Anticoagulant therapy is an important measure for preventing patients with atrial fibrillation from cerebral embolism. There are several significant shortcomings with the traditional oral anticoagulants, including warfarin. Therefore, anticoagulant therapy is far from the standards for the moment. New oral anticoagulants (NOACs, including direct thrombin inhibitors and Factor Xa inhibitors) have obviated many shortcomings of warfarin. Clinical trials have demonstrated that NOACs are superior or at least non-inferior to warfarin on preventing stroke and systemic embolisms in patients with non-valvular atrial fibrillation. NOACs also decreases the risk of bleeding events, especially intracranial bleeding. However, there is no specific antidote to reverse the anticoagulant effect of NOACs at present. This review