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[肺栓塞的新治疗方法:直接口服抗凝剂的试验结果及意义]

[New therapeutic approaches to pulmonary embolism: trials' results and significance of direct oral anticoagulants].

作者信息

Pizarro C, Hammerstingl C, Schaefer C, Grohé C, Nickenig G, Skowasch D

机构信息

Medizinische Klinik und Poliklinik II - Innere Medizin mit den Schwerpunkten Kardiologie, Angiologie und Pneumologie, Universitätsklinikum Bonn.

Klinik für Pneumologie, Evangelische Lungenklinik Berlin.

出版信息

Pneumologie. 2015 Feb;69(2):99-110. doi: 10.1055/s-0034-1391347. Epub 2015 Feb 10.

Abstract

Venous thromboembolisms (VTE) are frequently encountered emergencies that sometimes run a fatal course. Diagnostic and therapeutic strategies in patients with suspected pulmonary embolism (PE) are based on the presence of shock and hypotension. Oral anticoagulation is recommended for at least three months, extended anticoagulation should be considered for patients with unprovoked PE and low bleeding risk. As an alternative to vitamin K antagonists, direct oral anticoagulants are recommended. The present review discusses the mode of action, current data, and the status of rivaroxaban, dabigatran, apixaban and edoxaban in the treatment of PE - taking into account the new guidelines of the European Society of Cardiology and their clinical implementation.

摘要

静脉血栓栓塞症(VTE)是常见的急症,有时会发展为致命性病程。疑似肺栓塞(PE)患者的诊断和治疗策略基于休克和低血压的存在情况。建议口服抗凝治疗至少三个月,对于无诱因PE且出血风险低的患者应考虑延长抗凝治疗。作为维生素K拮抗剂的替代药物,推荐使用直接口服抗凝剂。本综述讨论了利伐沙班、达比加群、阿哌沙班和依度沙班在PE治疗中的作用方式、现有数据及地位——同时考虑到欧洲心脏病学会的新指南及其临床应用。

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