摘要
研究表明,无论是否合并心房颤动(房颤),心力衰竭(心衰)患者的血液均处于高凝状态,血栓栓塞的风险增大,严重影响患者预后。目前,预防性抗凝已广泛应用于合并房颤的心衰患者,但对于窦性心律心衰患者的抗凝治疗仍然存在争议。既往研究表明,抗凝治疗虽然可以有效降低心衰患者血栓栓塞风险,但其净收益被出血风险的增大所抵消,故不支持窦性心律心衰患者的常规抗凝,而低出血风险的新型口服抗凝药的出现,为窦性心律心衰患者的抗凝提供了新的选择。本文对窦性心律心衰患者发生血栓栓塞的流行病学、发生机制及其抗凝治疗的研究进展进行综述,探讨窦性心律心衰患者抗凝治疗的相关问题。
Studies have shown that regardless of whether it is combined with atrial fibrillation, the blood of patients with heart failure is in a hypercoagulable state, and the risk of thromboembolism increases, which seriously affects the prognosis of patients.At present, prophylactic anticoagulation has been widely used in patients with heart failure and atrial fibrillation, but it is still controversial in patients with heart failure and sinus rhythm.Most of studies have shown that anticoagulation therapy can effectively reduce the risk of thromboembolism in patients with heart failure, but its net benefit is offset by the increased of bleeding risk, so it does not support routine anticoagulation in patients with heart failure and sinus rhythm.The emergence of new oral anticoagulants with lower risk of bleeding provides a new choice for anticoagulation in patients with sinus rhythm and heart failure.In this review, we summarize the epidemiology and mechanisms of thromboembolism in patients with sinus rhythm heart failure and the related studies, and discuss the related problems of anticoagulant therapy in patients with these patients.
作者
胡有森
程兆云
张桥
孙俊杰
胡俊龙
刘前进
赵勇
HU You-sen;CHENG Zhao-yun;Zhang-qiao;SUN Jun-jie;HU Jun-long;LIU Qian-jin;ZHAO Yong(Department of Cardiovascular Surgery,Henan University People's Hospital,Henan Provincial People's Hospital,Zhengzhou 450003,China;Department of Cardiovascular Surgery,Henan University People's Hospital,Heart Center of Henan Provincial People's Hospital,Fuwai Cental China Cardiovascular Hospital,Zhengzhou 451464,China)
出处
《医药论坛杂志》
2022年第14期109-112,F0003,共5页
Journal of Medical Forum
关键词
窦性心律
心力衰竭
血栓栓塞
抗凝治疗
Sinus rhythm
Heart failure
Thromboembolism
Anticoagulant therapy
