JACC:口服抗凝药的出血管理专家共识

2017-12-04 佚名 国际循环

近日,美国心脏病学学会(ACC)发布了接受口服抗凝药(OAC)治疗的患者出血管理决策路径之专家共识。

近日,美国心脏病学学会(ACC)发布了接受口服抗凝药(OAC)治疗的患者出血管理决策路径之专家共识。密歇根大学Geoffrey D.Barnes教授概述其要点如下:

✲1.心房颤动及静脉血栓栓塞等疾病通常需要应用直接口服抗凝药(DOAC),且其应用还将持续增加。

✲2.出血是所有OAC包括DOAC的已知并发症,但其评估及管理仍面临重大挑战,尤其是对于长期应用DOAC的患者,这主要是因为缺乏比较容易的血液检测方法。

✲3.评估出血严重程度最关键的一步就是要询问:①是否曾发生过关键部位出血?②患者血流动力学是否不稳定?③是否曾发生过明显的临床出血使得血红蛋白下降≥2 g/dl或需输入两个单位的红细胞?

✲4.若出血不严重(即上述三个问题的答案都是否定的)或出血无需住院或外科/手术干预,则不应停用DOAC药物。

✲5.为评估是否达到发挥临床作用的药物水平,应用达比加群的患者应行稀释的凝血酶试验、ecarin凝结试验或ecarin显色试验。若采用敏感试剂所得出的活化部分凝血活酶时间(aPTT)正常则提示达比加群未达到临床作用水平。

✲6.为评估是否达到发挥临床作用的药物水平,应用Xa因子抑制剂(如阿哌沙班、依度沙班及利伐沙班)的患者应行抗Xa活性的显色分析检测。但PT及aPTT结果正常并不能排除应用Xa因子抑制剂的患者达到了临床作用水平。

✲7.逆转剂仅限于存在威胁生命的出血或关键部位大出血的患者应用。

✲8.为逆转维生素K拮抗剂(如华法令),若患者发生大出血事件可静脉应用5~10 mg维生素K,若患者发生需要住院的非大出血事件则可口服或静脉应用2~5 mg维生素K。

✲9.对于服用维生素K拮抗剂或Xa因子抑制剂的患者,若出现大出血则推荐应用4因子凝血酶原复合物(PCC)。其中,对于应用Xa因子抑制剂的患者,推荐的应用剂量为50单位/kg。

✲10.若患者应用达比加群时发生大出血,可静脉应用idarucizumab 5 g;若没有idarucizumab时可选择应用4因子PCC。

✲11.在出血得到控制后,应进行共同决策讨论确定是否需要及何时重新开始DOAC治疗。若出血为关键部位出血、患者存在较高的再出血或因再出血死亡风险、无法确定出血来源或是未来拟行外科手术,则建议延迟重新开始DOAC治疗。

✲12.对于出现胃肠道出血的患者,在7天以后重新开始OAC结局会更好,有助于改善生存率并降低血栓栓塞风险。

✲13.对于颅内出血患者,则应至少延迟约4周重新开始口服抗栓药物治疗。

原始出处:

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (7)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1853863, encodeId=049e1853863c4, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Mar 07 18:32:00 CST 2018, time=2018-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844945, encodeId=694f184494511, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Mon Mar 26 18:32:00 CST 2018, time=2018-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325622, encodeId=90bf132562214, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Dec 06 13:32:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377392, encodeId=b77913e739290, content=<a href='/topic/show?id=3098382134a' target=_blank style='color:#2F92EE;'>#口服抗凝药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38213, encryptionId=3098382134a, topicName=口服抗凝药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49ef408, createdName=hunizi005, createdTime=Wed Dec 06 13:32:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266876, encodeId=62182668e6a4, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Dec 05 06:43:42 CST 2017, time=2017-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266818, encodeId=e4b126681859, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5KiblTyxD95ExbzUoCVcRuhPibXboL28wicFMTXUhCA0RWCyQZYC5Na3ap7CxjialMkB50VEJ0XToQQTC/0, createdBy=470c1945776, createdName=方舒, createdTime=Mon Dec 04 22:48:49 CST 2017, time=2017-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266815, encodeId=33d126681581, content=学习.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Dec 04 22:39:57 CST 2017, time=2017-12-04, status=1, ipAttribution=)]
    2018-03-07 hbwxf
  2. [GetPortalCommentsPageByObjectIdResponse(id=1853863, encodeId=049e1853863c4, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Mar 07 18:32:00 CST 2018, time=2018-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844945, encodeId=694f184494511, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Mon Mar 26 18:32:00 CST 2018, time=2018-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325622, encodeId=90bf132562214, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Dec 06 13:32:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377392, encodeId=b77913e739290, content=<a href='/topic/show?id=3098382134a' target=_blank style='color:#2F92EE;'>#口服抗凝药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38213, encryptionId=3098382134a, topicName=口服抗凝药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49ef408, createdName=hunizi005, createdTime=Wed Dec 06 13:32:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266876, encodeId=62182668e6a4, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Dec 05 06:43:42 CST 2017, time=2017-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266818, encodeId=e4b126681859, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5KiblTyxD95ExbzUoCVcRuhPibXboL28wicFMTXUhCA0RWCyQZYC5Na3ap7CxjialMkB50VEJ0XToQQTC/0, createdBy=470c1945776, createdName=方舒, createdTime=Mon Dec 04 22:48:49 CST 2017, time=2017-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266815, encodeId=33d126681581, content=学习.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Dec 04 22:39:57 CST 2017, time=2017-12-04, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1853863, encodeId=049e1853863c4, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Mar 07 18:32:00 CST 2018, time=2018-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844945, encodeId=694f184494511, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Mon Mar 26 18:32:00 CST 2018, time=2018-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325622, encodeId=90bf132562214, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Dec 06 13:32:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377392, encodeId=b77913e739290, content=<a href='/topic/show?id=3098382134a' target=_blank style='color:#2F92EE;'>#口服抗凝药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38213, encryptionId=3098382134a, topicName=口服抗凝药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49ef408, createdName=hunizi005, createdTime=Wed Dec 06 13:32:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266876, encodeId=62182668e6a4, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Dec 05 06:43:42 CST 2017, time=2017-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266818, encodeId=e4b126681859, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5KiblTyxD95ExbzUoCVcRuhPibXboL28wicFMTXUhCA0RWCyQZYC5Na3ap7CxjialMkB50VEJ0XToQQTC/0, createdBy=470c1945776, createdName=方舒, createdTime=Mon Dec 04 22:48:49 CST 2017, time=2017-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266815, encodeId=33d126681581, content=学习.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Dec 04 22:39:57 CST 2017, time=2017-12-04, status=1, ipAttribution=)]
    2017-12-06 爆笑小医
  4. [GetPortalCommentsPageByObjectIdResponse(id=1853863, encodeId=049e1853863c4, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Mar 07 18:32:00 CST 2018, time=2018-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844945, encodeId=694f184494511, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Mon Mar 26 18:32:00 CST 2018, time=2018-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325622, encodeId=90bf132562214, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Dec 06 13:32:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377392, encodeId=b77913e739290, content=<a href='/topic/show?id=3098382134a' target=_blank style='color:#2F92EE;'>#口服抗凝药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38213, encryptionId=3098382134a, topicName=口服抗凝药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49ef408, createdName=hunizi005, createdTime=Wed Dec 06 13:32:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266876, encodeId=62182668e6a4, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Dec 05 06:43:42 CST 2017, time=2017-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266818, encodeId=e4b126681859, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5KiblTyxD95ExbzUoCVcRuhPibXboL28wicFMTXUhCA0RWCyQZYC5Na3ap7CxjialMkB50VEJ0XToQQTC/0, createdBy=470c1945776, createdName=方舒, createdTime=Mon Dec 04 22:48:49 CST 2017, time=2017-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266815, encodeId=33d126681581, content=学习.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Dec 04 22:39:57 CST 2017, time=2017-12-04, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1853863, encodeId=049e1853863c4, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Mar 07 18:32:00 CST 2018, time=2018-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844945, encodeId=694f184494511, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Mon Mar 26 18:32:00 CST 2018, time=2018-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325622, encodeId=90bf132562214, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Dec 06 13:32:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377392, encodeId=b77913e739290, content=<a href='/topic/show?id=3098382134a' target=_blank style='color:#2F92EE;'>#口服抗凝药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38213, encryptionId=3098382134a, topicName=口服抗凝药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49ef408, createdName=hunizi005, createdTime=Wed Dec 06 13:32:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266876, encodeId=62182668e6a4, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Dec 05 06:43:42 CST 2017, time=2017-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266818, encodeId=e4b126681859, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5KiblTyxD95ExbzUoCVcRuhPibXboL28wicFMTXUhCA0RWCyQZYC5Na3ap7CxjialMkB50VEJ0XToQQTC/0, createdBy=470c1945776, createdName=方舒, createdTime=Mon Dec 04 22:48:49 CST 2017, time=2017-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266815, encodeId=33d126681581, content=学习.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Dec 04 22:39:57 CST 2017, time=2017-12-04, status=1, ipAttribution=)]
    2017-12-05 1209e435m98(暂无昵称)

    学习了.谢谢分享!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1853863, encodeId=049e1853863c4, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Mar 07 18:32:00 CST 2018, time=2018-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844945, encodeId=694f184494511, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Mon Mar 26 18:32:00 CST 2018, time=2018-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325622, encodeId=90bf132562214, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Dec 06 13:32:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377392, encodeId=b77913e739290, content=<a href='/topic/show?id=3098382134a' target=_blank style='color:#2F92EE;'>#口服抗凝药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38213, encryptionId=3098382134a, topicName=口服抗凝药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49ef408, createdName=hunizi005, createdTime=Wed Dec 06 13:32:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266876, encodeId=62182668e6a4, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Dec 05 06:43:42 CST 2017, time=2017-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266818, encodeId=e4b126681859, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5KiblTyxD95ExbzUoCVcRuhPibXboL28wicFMTXUhCA0RWCyQZYC5Na3ap7CxjialMkB50VEJ0XToQQTC/0, createdBy=470c1945776, createdName=方舒, createdTime=Mon Dec 04 22:48:49 CST 2017, time=2017-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266815, encodeId=33d126681581, content=学习.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Dec 04 22:39:57 CST 2017, time=2017-12-04, status=1, ipAttribution=)]
    2017-12-04 方舒

    学习

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1853863, encodeId=049e1853863c4, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Mar 07 18:32:00 CST 2018, time=2018-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1844945, encodeId=694f184494511, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Mon Mar 26 18:32:00 CST 2018, time=2018-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325622, encodeId=90bf132562214, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Dec 06 13:32:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377392, encodeId=b77913e739290, content=<a href='/topic/show?id=3098382134a' target=_blank style='color:#2F92EE;'>#口服抗凝药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38213, encryptionId=3098382134a, topicName=口服抗凝药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49ef408, createdName=hunizi005, createdTime=Wed Dec 06 13:32:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266876, encodeId=62182668e6a4, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Dec 05 06:43:42 CST 2017, time=2017-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266818, encodeId=e4b126681859, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5KiblTyxD95ExbzUoCVcRuhPibXboL28wicFMTXUhCA0RWCyQZYC5Na3ap7CxjialMkB50VEJ0XToQQTC/0, createdBy=470c1945776, createdName=方舒, createdTime=Mon Dec 04 22:48:49 CST 2017, time=2017-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266815, encodeId=33d126681581, content=学习.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Mon Dec 04 22:39:57 CST 2017, time=2017-12-04, status=1, ipAttribution=)]
    2017-12-04 天地飞扬

    学习.谢谢分享!

    0

相关资讯

Blood:口服抗凝药对肝素诱导性血小板减少症的疗效

肝素诱导性血小板减少症(HIT)发生在临床上应用肝素治疗后诱发血小板减少,其发病机制可能与免疫机制有关。根据病程进展,可以分为暂时性血小板减少和持久性血小板减少,表现为血小板减少,同时可伴随血栓形成和弥散性血管内凝血。

Eur Heart J:房颤患者口服抗凝药可减少痴呆!

由此可见,没有接受口服抗凝治疗的房颤患者发生痴呆的风险更高。这表明房颤患者早期开始抗凝治疗在保持认知功能上很有价值。

疗效相当,更少出血风险,达比加群酯新适应证在中国获批

日前,国家食品药品监督管理总局(CFDA)已批准新型口服抗凝药物泰毕全(通用名:达比加群酯)新适应证:治疗急性深静脉血栓形成(DVT)和/或肺栓塞(PE)以及预防相关死亡;预防复发性DVT和/或PE以及相关死亡。

AHA2017:RE-DUAL PCI亚组分析:房颤患者应用新型口服抗凝药/氯吡格雷双联抗栓治疗更安全有效

2017年美国心脏协会(AHA)科学年会,在抗栓late-breaking重磅研究专题中,RE-DUAL PCI主要研究者之一、瑞典乌普萨拉大学Jonas Oldgren教授报道了最新亚组分析结果。

Heart: 口服抗凝药对房颤患者肝损伤小于华法林

2017年6月,《Heart》上发表了由美国科学家进行的口服抗凝和房颤(AF)患者肝损伤风险的前瞻性研究。

Int J Cardiol:肥厚型心肌病合并房颤患者直接口服抗凝药疗效如何?

2017年12月,发表在《Int J Cardiol》的一项研究调查了肥厚型心肌病(HCM)合并房颤(AF)患者使用直接口服抗凝药(NOACs)进行抗凝的疗效。