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心房颤动(AF)是心源性卒中的重要病因,尤其见于高龄人群。传统的以华法林为代表的抗凝治疗是有充分证据证明且得到各种指南推荐的预防心源性卒中的方法,但其治疗窗狭窄和需要定期检测明显地影响其广泛使用。近年来,以达比加群酯为代表的凝血酶直接抑制剂及以利伐沙班、艾吡沙班为代表的激活Ⅹ因子抑制剂成为新型抗凝治疗药物,在对重大骨科手术人群中获得比华法林或肝素更为安全有效的预防静脉血栓事件的疗效,并在中-高危的AF患者中被证明能预防心源性卒中或重要的系统性血栓栓塞事件,其疗效不劣于或优于华法林或肝素,颅内出血则明显少于华法林。这些新抗凝药物将成为一类全新的预防心源性卒中的治疗选择。
Atrial fibrillation (AF) is an important cause of cardioembolic stroke, especially in the elderly. Traditional anticoagulant therapy, such as warfarin, is well documented and recommended by various guidelines to prevent cardioembolic stroke, but its narrowing of treatment windows and the need for periodic testing significantly affect its widespread use. In recent years, direct inhibitors of dabigatran such as thrombin and active factor X inhibitors, which are represented by rivaroxaban and aliskapan, have become novel anticoagulant drugs. In patients with major orthopedic surgery The efficacy of a safer and more effective prophylaxis against venous thromboembolism than warfarin or heparin has been shown to prevent cardioembolic or essential systemic thromboembolic events in moderate-to-high-risk patients with AF that are not inferior in efficacy to Or better than warfarin or heparin, intracranial hemorrhage was significantly less than warfarin. These new anticoagulants will be a new class of treatment options for preventing cardioembolic stroke.