肺栓塞患者应用利伐沙班抗凝时的监测手段及临床意义  

Monitoring methods of rivaroxaban in patients with pulmonary embolism and the clinical significance

作　　者：李宜瑶 孙雪峰[1] 施举红[1] LiYiyao;Sun Xuefeng;Shi Juhong(Department of Pulmonary and Critical Care Medicine,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院呼吸与危重症医学科,北京100730

出　　处：《国际呼吸杂志》2024年第10期1137-1142,共6页International Journal of Respiration

基　　金：国家重点研发计划(2023YFC2507204);中央高水平医院临床科研专项重点培育项目(2022-PUMCH-C-017)。

摘　　要：利伐沙班是活化X因子(Xa)的特异性抑制剂,近年间针对利伐沙班的抗凝监测研究层出不穷,监测项目包括药物浓度和临床常用的凝血指标。抗凝药物的监测可以为部分患者,尤其特殊人群如肾功能不全和高龄患者提供更多的用药信息,有望成为个体化用药剂量调整的理论依据,在肺栓塞患者中的应用潜力备受关注,对于改善利伐沙班抗凝治疗的安全性和有效性具有重要意义。本文总结了利伐沙班的药代动力学特征、临床常用的监测手段及监测场景,探讨了抗凝监测的临床意义。Rivaroxaban is a specific inhibitor of activated FactorX(Xa).In recent years,numerous studies have emerged regarding the anticoagulation monitoring of rivaroxaban,including the monitoring of drug concentration and commonly used coagulation indicators in clinical practice.Monitoring anticoagulant drugs can provide more useful information for the medications of certain patients,especially special populations with renal insufficiency and the elderly.It is expected to become a theoretical basis for individualized dose adjustments,and highly concerned in the application to patients with pulmonary embolism for improving the safety and effectiveness of rivaroxaban anticoagulant therapy.This article summarized the pharmacokinetic characteristics of rivaroxaban,commonly used clinical monitoring methods,and monitoring scenarios.We also explored the clinical significance of anticoagulation monitoring.

关 键 词：肺栓塞 利伐沙班 治疗药物监测 药物浓度 

分 类 号：R563.5[医药卫生—呼吸系统]