心房颤动合并冠心病患者经皮冠脉介入术后抗栓治疗的研究进展  

Antithrombotic Therapy in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention

作　　者：张金晶 吕建峰 周敬群[1] 代文静 黄迪[1] 孙培媛 ZHANG Jinjing;LYU Jianfeng;ZHOU Jingqun;DAI Wenjing;HUANG Di;SUN Peiyuan(Department of Cardiology,Affiliated Renhe Hospital of Three Gorges University,Yichang 443000,Hubei,China)

机构地区：[1]三峡大学附属仁和医院心血管内科,湖北宜昌443000

出　　处：《心血管病学进展》2020年第2期185-189,共5页Advances in Cardiovascular Diseases

基　　金：湖北省教育厅科学技术研究项目基金(B2019027)。

摘　　要：心房颤动合并冠心病患者经皮冠脉介入术后的抗栓治疗是临床工作者所面临的一个困境。传统的三联疗法即口服抗凝药+阿司匹林+P2Y12抑制剂出血率较高,现多项随机对照试验表明,新型口服抗凝药+P2Y12抑制剂疗法较传统三联疗法在不明显增加心血管不良事件的基础上能减少出血事件,但二联疗法较三联疗法孰优孰劣还不能下定论。未来的研究或许会为这类患者的治疗提供一个最优的疗法。现介绍这类患者抗栓疗法的最新进展,为临床实践提供参考。Antithrombotic treatment for patients with atrial fibrillation complicated with coronary artery disease after percutaneous coronary intervention poses a treatment dilemma to clinical workers.Traditional triple antithrombotic therapy comprising of aspirin,a P2Y12 inhibitor and an oral anticoagulant is associated with high bleeding rates,now some randomized controlled trials have shown that dual antithrombotic therapy comprising of NOACs and P2Y12 inhibitor can reduce bleeding events without significantly increasing ischemic events than triple antithrombotic therapy.Nevertheless,it may be too early to declare dual or triple therapy as a winner.Future research may provide an optimal treatment for these patients.This review will introduce the latest researches on antithrombotic therapy about these patients,and provide reference for clinical practice.

关 键 词：二联治疗 心房颤动 经皮冠脉介入术 抗栓治疗 

分 类 号：R541.4[医药卫生—心血管疾病] R541.75[医药卫生—内科学]