Resnick Stuart B, Resnick Stephanie H, Weintraub Joshua L, Kothary Nishita
Department of Radiology, New York Presbyterian/Columbia University Medical Center, New York, New York.
Semin Intervent Radiol. 2005 Jun;22(2):95-107. doi: 10.1055/s-2005-871864.
Interventional radiology techniques made possible by the antithrombotic properties of heparin have revolutionized treatment for a myriad of disorders. Newer low-molecular-weight heparins (LMWHs) offer several advantages over unfractionated heparin (UFH), especially in chronic settings. They are increasing in popularity for use during vascular procedures. However, LMWH shares limitations with UFH such as heterogeneity, nonspecificity, and induction of thrombocytopenia. These drawbacks have led to a search for the next generation of antithrombotic agents. Homogeneous drugs targeting specific coagulation cascade molecules are now available. The number of alternative anticoagulant drug combinations presents clinicians with a confusing array of choices. The strengths and weaknesses of UFH, LMWH, and direct antithrombin agents are presented. The promising future of LMWH and hirudins is discussed.
肝素的抗血栓特性使介入放射学技术得以实现，这彻底改变了对无数疾病的治疗方式。新型低分子量肝素（LMWH）相对于普通肝素（UFH）具有若干优势，尤其是在慢性疾病的治疗中。它们在血管手术中的应用越来越广泛。然而，LMWH与UFH一样存在局限性，如异质性、非特异性以及诱导血小板减少。这些缺点促使人们寻找下一代抗血栓药物。现在已有针对特定凝血级联分子的均质药物。多种替代抗凝药物组合让临床医生面临一系列令人困惑的选择。本文介绍了UFH、LMWH和直接抗凝血酶药物的优缺点。并讨论了LMWH和水蛭素充满希望的未来。
