心源性脑卒中的心房颤动患者新型口服抗凝药治疗时机的研究进展  

Research progress on timing of DOAC initiation after acute ischemic stroke in patients with atrial fibrillation

作　　者：汤舒洁 孙玉芳 项涛[1] TANG Shujie;SUN Yufang;XIANG Tao(The Third People’s Hospital of Chengdu,Chengdu 610031,China)

机构地区：[1]成都市第三人民医院,四川成都610031

出　　处：《中国实用神经疾病杂志》2024年第8期1053-1056,共4页Chinese Journal of Practical Nervous Diseases

基　　金：成都市卫计委科研课题(项目编号:2021217)。

摘　　要：心房颤动是最常见的持续性心律失常,其发病率和病死率较高。随着人口老龄化的不断进展,心房颤动已成为当今“社会流行病”。心房颤动患者由于心房丧失收缩功能,血液易在心房内瘀滞而形成血栓。若血栓脱落则可随着血液至全身各处,从而导致脑栓塞、肢体动脉栓塞等。急性缺血性脑卒中是心房颤动的并发症之一,具有高致残率、高致死率等特点。心房颤动患者经正规抗凝治疗可预防急性缺血性脑卒中的发生,但同时存在出血转化风险。目前对于心房颤动患者急性缺血性卒中后开始进行口服抗凝治疗的具体时间选择仍有争议。本文总结回顾了当前的指南以及相关随机对照研究,并对目前的研究现状进行阐述。Atrial fibrillation is the most common persistent arrhythmia with high morbidity and mortality.With the continuous progress of population aging,atrial fibrillation has become a“social epidemic”.In patients with atrial fibrillation,blood is easy to form thrombus due to the loss of atrial contractile function.If the thrombus falls off,it can follow the blood to the whole body,resulting in cerebral embolism,limb artery embolism,etc.Acute ischemic stroke is one of the complications of atrial fibrillation,with a high rate of disability and mortality.The occurrence of acute ischemic stroke can be prevented by regular anticoagulant therapy in patients with atrial fibrillation.However,there is a risk of bleeding transformation during anticoagulant therapy.Therefore,this treatment is contradictory.At present,the specific time to start oral anticoagulant therapy after acute ischemic stroke in patients with atrial fibrillation is still controversial.In this review,we summarize and review the current guidelines and relevant randomized controlled studies,and describe the current research status.

关 键 词：心房颤动 缺血性脑卒中 新型口服抗凝药(DOAC) 抗凝治疗 心源性脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]