LaMonte Marian P, Brown Philip M, Hursting Marcie J
University of Maryland School of Medicine, Baltimore, MD 21201-1595, USA.
Expert Rev Cardiovasc Ther. 2005 Jan;3(1):31-41. doi: 10.1586/14779072.3.1.31.
Argatroban, a direct thrombin inhibitor, effectively inhibits free and clot-bound thrombin without the need of a cofactor and exerts dose-dependent anticoagulant effects that are rapidly active and rapidly reversible (elimination half-life: 39-51 min). Argatroban provides predictable parenteral anticoagulation and is well tolerated with an acceptably low bleeding risk in a variety of clinical settings, including heparin-induced thrombocytopenia, acute ischemic stroke, percutaneous coronary intervention and hemodialysis. This review will discuss the clinical pharmacology and utility of argatroban; in particular, clinical trial experiences will be discussed in patients with, or at risk of, heparin-induced thrombocytopenia (where heparins must be avoided) including those requiring hemodialysis or percutaneous coronary intervention, and in patients with acute ischemic stroke (where heparins are not generally recommended).
阿加曲班是一种直接凝血酶抑制剂，可有效抑制游离和与凝块结合的凝血酶，无需辅助因子，并发挥剂量依赖性抗凝作用，起效迅速且作用可逆（消除半衰期：39 - 51分钟）。阿加曲班可提供可预测的肠外抗凝作用，在包括肝素诱导的血小板减少症、急性缺血性中风、经皮冠状动脉介入治疗和血液透析在内的各种临床环境中，耐受性良好，出血风险低至可接受程度。本综述将讨论阿加曲班的临床药理学和应用；特别是，将讨论肝素诱导的血小板减少症患者或有该风险的患者（必须避免使用肝素）（包括需要血液透析或经皮冠状动脉介入治疗的患者）以及急性缺血性中风患者（一般不推荐使用肝素）的临床试验经验。
