摘要
房颤（心房颤动）具有高病发率和高死亡率特点，随着我国人口老龄化不断推进，老年患者房颤形势不容乐观。目前，抗凝治疗已被国内外房颤指南推荐为防治房颤患者卒中的核心策略。近年来，随着抗凝药物不断更新与应用，老年房颤患者的抗凝药物治疗取得了重大进展，本文就传统与新型抗凝药物在房颤中的疗效及应用进行归纳总结，以期为老年房颤患者的抗凝药物工作提供一定指导。
关键词： 房颤；老年患者；抗凝药；华法林；达比加群酯；利伐沙班；阿哌沙班；依度沙班
Abstract
Atrial fibrillation (AF) has the characteristics of high morbidity and mortality. With the conti- nuous advancement of population aging in China, the situation of elderly patients with AF is not optimistic. At present, anticoagulation therapy has been recommended as the core strategy to prevent stroke in patients with atrial fibrillation by domestic and foreign atrial fibrillation guidelines. In recent years, with the continuous updating and application of anticoagulant drugs, the treatment of elderly patients with atrial fibrillation has made significant progress. This paper summarizes the efficacy and application of traditional and new anticoagulant drugs in atrial fibrillation, in order to provide some guidance for the work of anticoagulant drugs in elderly patients with atrial fibrillation.
Key words： Atrial fibrillation; Elderly patients; Anticoagulants; Warfarin; Dabigatran ester; Rivaroxaban; Apixaban; Idusaban
参考文献 References
[1] 吕程,何燕,许键,等.利伐沙班与华法林对心房颤动伴左心房血栓形成患者的疗效观察[J].中国循环杂志,2016,31(11):1098-1101.
[2] 张晓明,廖照亮.基层医院非瓣膜病性心房颤动患者抗凝治疗INR达标情况及影响因素分析[J].现代实用医学,2019,31(7):969-971.
[3] 何榕,刘元伟,佘飞,等.单中心不同科室住院的心房颤动患者抗凝治疗选择和影响因素分析[J].中国心血管杂志,2019,24(5):424-429.
[4] 鲁晶.136例心房颤动病人抗凝治疗效果及安全性分析[J].中西医结合心脑血管病杂志,2018,16(22):3324-3326..
[5] 汪爱民,徐小凤.华法林对心房颤动患者凝血功能及血流变指标影响浅析[J].西南医科大学学报,2019,42(5):462-465.
[6] 陈丽,宫玉霞,张秀林.利伐沙班与华法林治疗高龄(≥80岁)非瓣膜性心房颤动患者临床疗效的对比研究[J].实用心脑肺血管病杂志,2018,26(9):63-66.
[7] 邵伟.2016至2019年我院住院患者服用华法林的INR检测及随访效果[J].河北医药,2020,42(14):2208-2210.
[8] 陈文文,党和勤,耿涛,等.影响房颤患者华法林抗凝控制质量的因素分析[J].中国医院药学杂志,2016(24):2191-2194.
[9] 聂亚茹,吴建华,李贝贝,等.低剂量华法林对心房颤动患者脑卒中和凝血指标的影响[J].药物评价研究,2020,43(09):1844-1847.
[10] 吕雄胜,梅建华,陈小英.华法林对老年非瓣膜病合并房颤患者心功能、血小板活化及疗效的影响[J].中国老年学杂志,2019,39(7):22-24.