心房颤动合并慢性肾脏病患者口服抗凝药物治疗的研究进展

摘要/Abstract

摘要： 慢性肾病与心房颤动（房颤）密切相关并常常共存。慢性肾病和房颤均是血栓发生的危险因素，因此房颤合并慢性肾病人群其缺血性卒中及体循环栓塞的风险显著增加。对于普通的房颤人群，口服抗凝药物治疗是预防缺血性卒中和体循环栓塞发生的有效干预手段，并且慢性肾病还会增加出血风险，因此合并慢性肾病的房颤人群进行口服抗凝药物治疗可能并不具有临床净获益。目前针对房颤合并慢性肾病人群口服抗凝药物的疗效与安全性研究结论尚存争议，其获益风险比不明确。本文对房颤合并慢性肾病患者口服抗凝药物治疗现状作一综述，旨在为临床提供参考。

关键词: font-size:medium, ">font-size:medium, ">心房颤动；慢性肾病；口服抗凝药物治疗；华法林；新型口服抗凝剂

Abstract: Chronic kidney disease（CKD）and atrial fibrillation（AF）are closely related and often coexist. CKD and AF are both risk factors for thrombosis, so patients with concomitant CKD and AF have a significantly increased risk of ischemic stroke and systemic embolism. For the general population of AF, oral anticoagulant therapy （OAT）is an effective intervention to prevent ischemic stroke and systemic embolism. However, CKD also increases the risk of bleeding, so OAT in patients with concomitant CKD and AF may not provide a net clinical benefit. Currently, the efficacy and safety of oral anticoagulants（OACs） in patients with concomitant CKD and AF are controversial, and the benefit-to-risk ratio of OAT is still unclear. In view of this, this review summarized the existing evidence and recommendations of OAT for patients with concomitant CKD and AF, aiming to provide clinical reference.

Key words: font-size:medium, ">font-size:medium, ">Atrial fibrillation； Chronic kidney disease； Oral anticoagulation therapy； Warfarin； New oral anticoagulants

中图分类号:

龙国会, 宋沧桑, 李兴德, 张阳, 张函舒, 毛盼盼, 刘璐. 心房颤动合并慢性肾脏病患者口服抗凝药物治疗的研究进展[J]. 中国药物评价, 2022, 39(1): 54-60.

LONG Guo-hui, SONG Cang-sang, LI Xing-de, ZHANG Yang, ZHANG Han-shu, MAO Pan-pan, LIU Lu. Research Progress of Anticoagulant Therapy in Patients with Concomitant Atrial Fibrillation and Chronic Kidney Disease[J]. CHINESE JOURNAL OF DRUG EVALUATION, 2022, 39(1): 54-60.

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