Veltkamp Roland, Horstmann Solveig
Department of Stroke Medicine, Charing Cross Hospital, Imperial College London, Fulham Palace Road, London W6 8RF, UK; Department of Neurology, University of Heidelberg, INF 400, Heidelberg 69120, Germany.
Department of Neurology, University of Heidelberg, INF 400, Heidelberg 69120, Germany.
Clin Lab Med. 2014 Sep;34(3):587-94. doi: 10.1016/j.cll.2014.06.007. Epub 2014 Jul 29.
Intracerebral hemorrhage (ICH) associated with the use of oral anticoagulants (OAC-ICH) results in particularly severe strokes. A key target for the treatment of OAC-ICH is rapid restoration of effective coagulation. In patients receiving vitamin K antagonists, hemostatic factors such as prothrombin complex concentrate (PCC), fresh frozen plasma, and recombinant activated factor VII, in addition to vitamin K, can be used for anticoagulation reversal. However, emergency management of ICH during treatment with the new direct OACs (NOACs) is a major challenge. In the absence of specific antidotes, PCCs are recommended for NOAC reversal, mainly based on preclinical data.
与口服抗凝剂相关的脑出血（OAC-ICH）会导致特别严重的中风。治疗OAC-ICH的一个关键目标是迅速恢复有效的凝血功能。在接受维生素K拮抗剂治疗的患者中，除维生素K外，凝血酶原复合物浓缩物（PCC）、新鲜冰冻血浆和重组活化因子VII等止血因子可用于逆转抗凝作用。然而，在使用新型直接口服抗凝剂（NOACs）治疗期间对脑出血进行紧急处理是一项重大挑战。在缺乏特异性解毒剂的情况下，推荐使用PCC来逆转NOAC的作用，这主要基于临床前数据。
