预防心源性卒中的新型抗凝药物  

New anticoagulants for prevention of cardiogenic stroke

作　　者：李焰生[1] 

机构地区：[1]上海交通大学医学院附属仁济医院神经科,上海200127

出　　处：《中国新药杂志》2011年第11期981-984,共4页Chinese Journal of New Drugs

摘　　要：心房颤动(AF)是心源性卒中的重要病因,尤其见于高龄人群。传统的以华法林为代表的抗凝治疗是有充分证据证明且得到各种指南推荐的预防心源性卒中的方法,但其治疗窗狭窄和需要定期检测明显地影响其广泛使用。近年来,以达比加群酯为代表的凝血酶直接抑制剂及以利伐沙班、艾吡沙班为代表的激活Ⅹ因子抑制剂成为新型抗凝治疗药物,在对重大骨科手术人群中获得比华法林或肝素更为安全有效的预防静脉血栓事件的疗效,并在中-高危的AF患者中被证明能预防心源性卒中或重要的系统性血栓栓塞事件,其疗效不劣于或优于华法林或肝素,颅内出血则明显少于华法林。这些新抗凝药物将成为一类全新的预防心源性卒中的治疗选择。Atrial fibrillation （AF） is the major risk factor of the cardiogenic stroke, especially in the elderly. The efficacy of warfarin and related anticoagulants has been supported by plenty of evidence and they are recommended by different guidelines. However, the use of warfarin for prevention of stroke in AF patients is limited by narrow therapeutic window and need of regular coagulation monitoring. Recently, director thrombin inhibitors （ such as Dabigatran） and factor Xa inhibitors （ such as Rivaroxaban and Apixaban） have been proved to be effective and safe for prevention of thromboembolie events in major orthopedic surgery. They have been tested in moderate-high risk AF patients for prophylaxis of stroke and systemic embolic events. Their efficacy was superior or non-inferior to warfarin or heparin with less tendency of intracranial bleeding warfarin for stroke prophylaxis in AF patients These new anticoagulants will be the alternatives to

关 键 词：心房颤动 卒中 抗凝药物 凝血酶抑制剂 XA因子抑制剂 

分 类 号：R973.2[医药卫生—药品]