口服抗凝药与肾损害  

Oral anticoagulants and kidney injury

作　　者：杨文领[1] 唐子勇[1] 郑丹侠[1] 王悦[1] YANG Wenling;TANG Ziyong;ZHENG Danxia;WANG Yue(Department of Nephrology,Peking University Third Hospital,Beijing,100191, China)

机构地区：[1]北京大学第三医院肾内科,北京100191

出　　处：《临床心血管病杂志》2018年第12期1227-1231,共5页Journal of Clinical Cardiology

摘　　要：口服抗凝药包括维生素K拮抗剂和新型口服抗凝剂(NOACs)。近年来陆续有华法林和NOACs导致急性肾损伤(AKI)的报道,被称为抗凝剂相关肾病。其临床表现为应用抗凝剂后短时间内发生AKI,不能用其他原因解释,伴或不伴肉眼血尿;改善凝血后进行肾穿刺检查,组织学显示弥漫性肾小球出血,可见到肾小管内红细胞管型。本文综述口服抗凝剂的作用机制、药代动力学特点及其肾损害的特点、发病机制、危险因素、治疗原则和预后。Oral anticoagulants include traditional vitamin K antagonist and novel oral anticoagulants.There were several reports of acute kidney injury related with oral anticoagulants consecutively,which was called anticoagulants-related nephropathy.It presented as unexplained acute kidney injury with diffuse glomerular hemorrhage and renal tubular obstruction by red blood cell casts,accompanied by gross hematuria or not.This article reviews and highlights the pharmacodynamics characteristics of different oral anticoagulants,especially the clinicopathologic characteristics,pathogenesis,risk factors,treatment and prognosis of the related renal injury,which was intended to warrant safer anticoagulation.

关 键 词：口服抗凝剂 血尿 急性肾损伤 抗凝剂相关肾病 安全用药 

分 类 号：R541[医药卫生—心血管疾病]