新型口服抗凝药的药理学特点及其应用
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摘要
新型口服抗凝药(NOAC)与食物或其他药物相互作用少,可快速起效,生物利用度高,药代动力学确切,个体差异小,抗凝效果稳定,颅内出血并发症减少,患者服药依从性好,可用于长期治疗,且多数研究证实了NOAC对预防非瓣膜性房颤(NVAF)患者卒中、静脉血栓栓塞症(VTE)的有效性和安全性。
New oral anticoagulants(NOAC) show greater advantages,have less interaction with foods or other drugs,and with rapid onset,high bioavailability,exact pharmacokinetics and small individual differences.The anticoagulant effect is stable,which can reduce the intracranial hemorrhage complications,with good patient's medication compliance,which facilitate long-term treatment of patients.Clinical studies have confirmed the efficacy and safety of NOAC in the prevention of stroke and VTE in patients with NVAF.
New oral anticoagulants(NOAC) show greater advantages,have less interaction with foods or other drugs,and with rapid onset,high bioavailability,exact pharmacokinetics and small individual differences.The anticoagulant effect is stable,which can reduce the intracranial hemorrhage complications,with good patient's medication compliance,which facilitate long-term treatment of patients.Clinical studies have confirmed the efficacy and safety of NOAC in the prevention of stroke and VTE in patients with NVAF.
引文
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[13]GIUGLIANO R P,RUFF C T,BRAUNWALD E,et al. Edoxaban versus warfarin in patients with atrial fibrillation[J].N Engl J Med,2013,369(22):2093-2104.
[14]FDA.FDA approved betrixaban(BEVYXXA,Portola)for the prophylaxis of venous thromboembolism(VTE)in adult patients[EB/OL].[2017-06-23].https://www.fda.gov/drugs/informationondrugs/approveddrugs/ucm564422.htm.
[2]NOEL C C,JACK H,JEFFREY S G,et al.Betrixaban(PRT054021):pharmacology,dose selection and clinical studies[J].Future Cardiol,2014,10(1):43.
[3]MARIA I A,RUTH S K,WILLIAM D F.New anticoagulants(dabigatran, apixaban, rivaroxaban)for stroke prevention in atrial fibrillation[J].Neurol Clin,2013,31(3):659.
[4]CURTO A,ALBALADEJO A.Implications of apixaban for dental treatments[J].J Clin Exp Dent,2016,8(5):e611-614.
[5]SPRYNGER M.Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism[J].Rev Med Liege,2013,68(10):548.
[6]PARASRAMPURIA D A,WEILERT D,MAA J F,et al.Pharmacokinetics and Pharmacodynamics of the nonvitamin K antagonist oral anticoagulant edoxaban when administered alone or after switching from rivaroxaban or dabigatranet exilate in healthy subjects[J].Clin Drug Invest,2016,36(2):127.
[7]GARNOCK-JONES K P.Dabigatran etexilate:a review of its use in the prevention of stroke and systemic embolism in patients with atrial fibrillation[J].Am J Cardiovasc Drugs,2011,11(1):57-72.
[8]CHAN P H,HUANG D,HAI J J,et al. Stroke prevention using dabigatran in elderly Chinese patients with atrial fibrillation[J].Heart Rhythm,2016,13(2):366-373.
[9]MAJEED A,GOLDHABER S Z,KAKKAR A,et al.Bleeding eventswithdabigatranorwarfarininpatientswithvenous thromboembolism[J].Thromb Haemost,2016,115(2):291-298.
[10]PATEL M R,MAHAFFEY K W,GARG J,et al.Rivaroxaban versus warfarin innonvalvular atrial fibrillation[J].N Engl J Med,2011,365(10):883-891.
[11]CAMM A J,AMARENCO P,HAAS S,et al.XANTUS:a realworld, prospective, observational study of patients treated with rivaroxaban for stroke prevention in atrial fibrillation[J].Eur Heart J,2016,37(14):1145-1153.
[12]WALLENTIN L,LOPES R D,HANNA M,et al. Efficacy and safety of apixaban compared with warfarin dt different levels of predicted international normalized ratio control for stroke prevention in atrial fibrillation[J].Circulation,2013,127(22):2166-2176.
[13]GIUGLIANO R P,RUFF C T,BRAUNWALD E,et al. Edoxaban versus warfarin in patients with atrial fibrillation[J].N Engl J Med,2013,369(22):2093-2104.
[14]FDA.FDA approved betrixaban(BEVYXXA,Portola)for the prophylaxis of venous thromboembolism(VTE)in adult patients[EB/OL].[2017-06-23].https://www.fda.gov/drugs/informationondrugs/approveddrugs/ucm564422.htm.