凝血因子FⅪ/FⅪa抑制剂:抗凝新选择?  

FⅪ/FⅪa inhibitors:a new option for anticoagulation?

作　　者：曹颖 公奥博 童瑶 胡贤进 李芳卉 曾锐[1] CAO Ying;GONG Ao-bo;TONG Yao;HU Xian-jin;LI Fang-hui;ZENG Rui(Department of Cardiology,West China Hospital,Sichuan University West China School of Medicine,Chengdu 610044,China)

机构地区：[1]四川大学华西医院心内科,四川成都610044

出　　处：《中国实用内科杂志》2024年第2期120-127,共8页Chinese Journal of Practical Internal Medicine

基　　金：四川省科学技术项目(2022JDRC0148)。

摘　　要：血栓形成是多种疾病致死的重要原因,抗凝治疗是抑制血栓形成的主要方法。但目前临床常用的抗凝药物因出血风险致应用受限,对需要长期抗凝治疗的心房颤动(简称房颤)患者尤甚,所以有必要研究开发更加有效安全的抗凝药物。研究者们深入研究凝血机制,发现凝血因子FⅪ/FⅪa抑制剂存在有效抗凝而不影响生理止血的潜能。目前已有多项涉及房颤以及其他疾病(如心肌梗死、脑卒中等)领域的临床Ⅱ期试验提示FⅪ/FⅪa抑制剂相较直接口服抗凝剂(DOACs)存在更低的出血风险,有待临床Ⅲ期试验的进一步研究验证,有望成为抗凝新选择。笔者将在临床实践的基础上探讨FⅪ/FⅪa抑制剂的抗凝机制、研究进展和应用前景。Thrombosis is a significant cause of death in a variety of diseases,and anticoagulation is the main method of thrombosis inhibition.Nevertheless,currently in clinical practice,the application of most commonly used anticoagulant drugs is limited due to the risk of bleeding,particularly for patients with atrial fibrillation who require long-term anticoagulant therapy.Therefore,it is necessary to explore and develop more effective and safer anticoagulant drugs.Researchers have studied the coagulation mechanism in depth and found that FⅪ/FⅪa inhibitors have the potential to effectively inhibit coagulation without affecting physiological hemostasis.So far,a few clinical phaseⅡtrials involving atrial fibrillation and other diseases(such as myocardial infarction,stroke,etc.)suggest that FⅪ/FⅪa inhibitors tend to have a lower bleeding risk than direct oral anticoagulants(DOACs),which requires further studies in clinical phaseⅢtrials to verify their effectiveness and safety.Potentially,FⅪ/FⅪa inhibitors are expected to be a new option for anticoagulation.Based on clinical practice,the author will discuss the anticoagulation mechanism,research progress and application prospects of FⅪ/FⅪa inhibitors.

关 键 词：FⅪ/FⅪa抑制剂 抗凝治疗 心房颤动 血栓形成 

分 类 号：R973[医药卫生—药品]