直接凝血酶抑制剂在体外循环期间抗凝治疗的研究进展  

Advancements in the application of direct thrombin inhibitors in cardiopulmonary bypass anticoagulation therapy

作　　者：王赫 刘晋萍[1] Wang He;Liu Jinping(Department of Cardiopulmonary Bypass,National Center for Cardiovascular Disease,Chinese Academy of Medical Sciences&Peking Union Medical College Fuwai Hospital,Beijing 100037,China)

机构地区：[1]中国医学科学院北京协和医学院,国家心血管病中心阜外医院体外循环中心,北京100037

出　　处：《中国体外循环杂志》2024年第3期242-245,256,共5页Chinese Journal of Extracorporeal Circulation

基　　金：中国医学科学院阜外医院高水平医院临床科研项目(2022-GSP-GG-22)。

摘　　要：肝素是目前心脏外科体外循环期间抗凝治疗标准药物,但肝素过敏或肝素诱导性血小板减少症等不良反应逐渐受人关注。直接凝血酶抑制剂(DTIs)可直接与凝血酶结合,不出现上述不良反应,因此被推荐应用在可能出现肝素/鱼精蛋白不良反应且需要紧急手术患者的体外循环期间抗凝管理。近年来DTIs的临床病例报道较多,本文将简要综述DTIs的抗凝机制及几种药物的临床应用进展,为体外循环期间抗凝治疗提供新思路。Heparin is currently the standard drug for anticoagulation during cardiopulmonary bypass(CPB)in cardiac surgery,but its adverse reactions,such as heparin allergy or heparin-induced thrombocytopenia(HIT),have been increasingly concerned.Direct thrombin inhibitors(DTIs),which directly bind to thrombin without the aforementioned adverse reactions,are recommended for anticoagulation management during CPB in patients experiencing heparin/protamine adverse reactions and requiring emergency surgery.In recent years,there have been many clinical case reports of DTIs.This article will briefly review the anticoagulation mechanism of DTIs and the clinical application progress of several drugs,providing new insights for anticoagulation treatment during CPB.

关 键 词：直接凝血酶抑制剂 体外循环 肝素诱导性血小板减少症 抗凝 

分 类 号：R654.1[医药卫生—外科学]