新型Xa因子抑制剂——依度沙班在心房颤动患者抗凝治疗中的研究进展  

Novel Factor Xa Inhibitors——Edoxaban in Prevention of Stroke in Patients with Atrial Fibrillation

作　　者：张清[1] 罗素新[1] 唐炯[2] 

机构地区：[1]重庆医科大学附属第一医院心血管内科,重庆400016 [2]成都市第三人民医院心血管内科,四川成都610031

出　　处：《心血管病学进展》2016年第2期151-155,共5页Advances in Cardiovascular Diseases

基　　金：国家重点基础研究发展计划(2014CB542400);国家自然科学基金面上项目(81170112;81270210);重庆市科委课题(CSTC2012jj A10143);国家临床重点专科建设项目经费资助【财社(2011)170号】

摘　　要：心房颤动是最常见的心律失常,也是缺血性卒中的主要危险因素之一。一直以来华法林都是心房颤动患者预防脑卒中和系统性血栓的一线抗凝药,但由于其治疗窗窄、药物及食物之间相互作用,需频繁监测国际标准化比值等不足,限制了其在临床上的应用。新型口服抗凝药如达比加群酯、利伐沙班和阿哌沙班目前均已上市,且广泛用于非瓣膜性心房颤动患者预防脑卒中和系统性血栓的治疗中。依度沙班是最新的用于抗凝治疗的Xa因子抑制剂,实验结果显示,依度沙班在非瓣膜性心房颤动患者预防脑卒中及系统性血栓事件上效果不亚于华法林,总的出血事件及心血管死亡事件发生率更低。现对依度沙班的临床研究及临床应用进展做一综述。Atrial fibrillation is the most common arrhythmia,and patients with atrial fibrillation are susceptible to developing cardioembolic stroke. Warfarin has traditionally been used for stroke prevention. Although effective warfarin use has multiple concerns,such as a narrow therapeutic window,drug-drug and drug-food interactions and frequent need of INR monitoring. Novel oral anticoagulant agents（ direct thrombin inhibitor dabigatran and factor Xa inhibitors like rivaroxaban and apixaban） have recently become available as viable alternatives for warfarin therapy. Edoxaban is the latest oral direct factor Xa inhibitor studied in the largest novel oral anticoagulant trial so far. Edoxaban was found to be non-inferior to dose-adjusted warfarin in reducing the rate of stroke and systemic embolism in patients with non-valvular atrial fibrillation,with a lower incidence of bleeding complications and cardiovascular deaths. This article reviews the clinical trials and progress of clinical application of edoxaban.

关 键 词：心房颤动 脑卒中 新型口服抗凝药 XA因子抑制剂 依度沙班 

分 类 号：R541.75[医药卫生—心血管疾病]