未来心房颤动抗栓——谁主沉浮  

New Medicine for Antithrombotic Treatment of Atrial Fibrillation—Who Can Dominate in the Future

作　　者：陈敏华[1] 王兴祥[1] 

机构地区：[1]浙江大学医学院附属第一医院心内科,浙江杭州310003

出　　处：《心血管病学进展》2008年第2期185-189,共5页Advances in Cardiovascular Diseases

摘　　要：心房颤动(房颤)是导致缺血性脑卒中的主要危险因素,因此抗栓治疗是房颤治疗的核心。目前临床上最常用的抗栓药物是华法林,但其具有治疗窗窄、易出血、需定期监测凝血功能等缺陷,需要我们去积极探索新的抗栓药物。直接凝血酶抑制剂、Ⅹa因子抑制剂及REG1等药物的发现给房颤抗栓治疗带来了新的曙光。这些药物大多已被多项临床试验结果证明具有抗栓作用,且可以弥补华法林的不足,至于能否替代华法林用于房颤的抗栓治疗,有待正在进行或正在积极准备的相关研究来回答。现回顾近年来相关临床研究的结果,分析目前新型抗凝药物中谁最有可能主导未来房颤的抗栓治疗。Atrial fibrillation （Af） is a major potent risk factor for ischemic stroke. So,we should pay intensive attention to antithromboric treatment of Af. Currently,warfarin is the most frequently used anticoagulant for stroke prevention in patients with Af. Although effective, warfarin has many shortcomings ,such as narrow therapeutic range, easily caused bleeding, and requiring regular coagulation monitoring and dose adjustment. Therefore,efforts to identify and implement efficacious and acceptably Safe strategies are paramount. Novel antithrombotic agents,including direct thrombin inhibitors, factor Xa inhibitors and REG1 ,have already been demonstrated by various clinical studies that they can inhibit thrombosis efficaciously but without the limitations of warfarin. Furthermore, studies of these agents for stroke prevention in patients with Af are planned or ongoing. This article reviewed the existing randomized trial evidence of these agents in order to find who may represent the next generation of anticoagulants by providing new therapeutic options for stroke prevention in patients with Af.

关 键 词：心房颤动 抗栓治疗 直接凝血酶抑制剂 XA因子抑制剂 REG1 

分 类 号：R541.75[医药卫生—心血管疾病]