Jackson Larry R, Becker Richard C
Division of Cardiology, Department of Medicine, Duke Clinical Research Institute, Duke University School of Medicine, DUMC 3850, Durham, NC, 27710, USA,
J Thromb Thrombolysis. 2014 Apr;37(3):380-91. doi: 10.1007/s11239-013-0958-0.
Novel oral anticoagulants (NOAC) provide an effective and, in some cases, superior alternative to traditional, oral vitamin K antagonists such as warfarin. These drugs differ in their pharmacokinetic and pharmacodynamics profiles, which is important for selecting the right drug for the right patient. A concern among clinicians is a virtual absence of guidance from clinical trials for reversing the anticoagulant effects of these drugs in clinical settings such as life-threatening bleeding or a need for emergent procedures that carry bleeding risk. In this review, we discuss NOAC, the role of coagulation assays to assess their systemic anticoagulants effects, and the available data supporting strategies designed to reverse or attenuate these effects.
新型口服抗凝药（NOAC）为传统口服维生素K拮抗剂（如华法林）提供了一种有效且在某些情况下更优的替代方案。这些药物在药代动力学和药效学方面存在差异，这对于为合适的患者选择合适的药物很重要。临床医生关注的一个问题是，在诸如危及生命的出血或需要进行有出血风险的紧急手术等临床情况下，几乎没有来自临床试验的关于逆转这些药物抗凝作用的指导。在本综述中，我们讨论了新型口服抗凝药、凝血检测在评估其全身抗凝作用中的作用，以及支持旨在逆转或减弱这些作用的策略的现有数据。
