达比加群抗凝治疗期间心房颤动患者左心耳血栓形成的原因分析  

Causes of Left Atrial Appendage Thrombosis in Patients with Atrial Fibrillation During Anticoagulation with Dabigatran

作　　者：李黎[1] 钱鑫[1] 严春宏[1] 梅茜 谢娟[1] 张进华[2] 边原[3] LI Li;QIAN Xin;YAN Chunhong;MEI Qian;XIE Juan;ZHANG Jinhua;BIAN Yuan(Dept. of Pharmacy, Guizhou Provincial People’s Hospital, Guizhou Guiyang 550002, China;Dept. of Pharmacy, Fujian Medical University Union Hospital, Fujian Fuzhou 350001, China;Dept. of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Affiliated Hospital of University of Electronic Science and Technology of China, Sichuan Key Laboratory of Individualized Drug Therapy, Sichuan Chengdu 610072, China)

机构地区：[1]贵州省人民医院药剂科,贵州贵阳550002 [2]福建医科大学附属协和医院药学部,福建福州350001 [3]四川省医学科学院·四川省人民医院,电子科技大学附属医院药学部,个体化药物治疗四川省重点实验室,四川成都610072

出　　处：《中国医院用药评价与分析》2020年第3期381-384,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：四川省省级公益性科研院所基本科研业务专项课题(No.2018YSKY0017)。

摘　　要：达比加群是近年来用于非瓣膜性心房颤动脑卒中预防的直接凝血酶抑制剂类新型口服抗凝血药(new oral anticoagulant,NOAC),推荐用于无禁忌证的初始抗凝治疗患者或华法林抗凝达标不佳的患者。在临床实践中,仍偶见依从性良好的心房颤动患者在使用NOAC进行规律抗凝治疗期间有左心耳血栓(left atrial appendage thrombus,LAAT)形成。这是机体本身的原因还是药物的疗效或安全性问题值得探讨。本文就规律口服达比加群抗凝治疗期间发生LAAT形成的原因进行综述与分析,为临床诊疗提供参考。Dabigatran is the new oral anticoagulant(NOAC)of direct thrombin inhibitors for the prevention of stroke derived from non-valvular atrial fibrillation in recent years,which is recommended in patients with initial anticoagulant therapy without contraindications or in patients with poor anticoagulant compliance with warfarin.In clinical practice,it is still occasionally observed that patients with atrial fibrillation with good compliance have left atrial appendage thrombus(LAAT)formation during regular anticoagulation treatment with NOAC.Whether this is due to the body itself,the efficacy or safety of the drug still deserves the further discussion.This article reviews the causes of LAAT during regular oral anticoagulant therapy,and provides reference for clinical diagnosis and treatment.

关 键 词：达比加群 左心耳 血栓 抗凝治疗 

分 类 号：R973.2[医药卫生—药品]