肿瘤合并房颤患者抗凝治疗进展.PDF

《中国医学前沿杂志 （电子版）》2017 年第9 卷第9 期 ● ●  7  重点号专题  DOI ：10.12037/YXQY.2017.09-02 肿瘤合并房颤患者抗凝治疗进展 袁铭，刘彤 （天津医科大学第二医院　心脏科　天津市科委心血管疾病离子和分子功能重点实验室　天津 心脏病学研究所，天津　3002 11） 【摘要】心房颤动 （房颤）是临床上最常见的持续性心律失常，随着全球人口老龄化，房颤的发病率 也逐年升高。除心脏瓣膜病和高血压等心血管疾病易导致房颤外，房颤也可发生在甲状腺功能障碍和 慢性阻塞性肺疾病等患者中。越来越多的研究指出，肿瘤患者的房颤发生率逐年升高，可能是未来一 项重要的公共卫生问题。血栓栓塞事件可能是肿瘤合并房颤患者最严重的并发症。抗凝治疗可以显著 减少缺血性卒中的发生，但同时可能增加出血风险。目前，有关肿瘤合并房颤患者抗凝治疗方面的临 床证据相对较少，本文就肿瘤合并房颤患者抗凝治疗的最新进展进行综述。 【关键词】肿瘤 ；心房颤动；血栓栓塞；出血；抗凝治疗 Anticoagulation therapy for atrial fibrillation in patients with cancer YUAN Ming, LIU Tong (Department of Cardiology, Second Hospital of Tianj in Medical University, Tianj in Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Tianj in Institute of Cardiology, Tianj in 3002 11, China) Corresponding author: LIU Tong, E-mail: liutongdoc@126.com Abstract 【 】Atrial fibrillation (AF) is the most common sustained arrhythmia in clincial practice. With the aging of the global population, the incidence of AF is increasing year by year. In addition to heart valve disease, hypertension and other cardiovascular disease which may induce AF, it can also occur in thyroid dysfunction, chronic obstructive pulmonary disease. More and more studies have showed that the incidence of AF in cancer patients is increasing, and may becoming a maj or public health problem in the future. Thromboembolic events may be the most serious complication of cancer patients with AF. Anticoagulant therapy can significantly reduce the incidence of ischemic stroke, but there is still an increased bleeding risk. However, there are no established clinical guidelines for anticoagulation managementof cancer patients with AF, especially regarding the selection of anti-thrombotic therapy. The pres