非维生素K拮抗口服抗凝剂在急性冠脉综合征中的应用
Application of Non-Vitamin K Antagonist Oral Anticoagulants in Acute Coronary Syndrome
DOI: 10.12677/acm.2025.1572001, PDF,    科研立项经费支持
作者: 潘 港, 黄诗豪：岳阳市中心医院心血管内科，湖南 岳阳
关键词: 非维生素K拮抗口服抗凝剂；急性冠脉综合征；综述；Non-Vitamin K Antagonist Oral Anticoagulants (NOACs)； Acute Coronary Syndrome (ACS)； Review
摘要: 非维生素K拮抗口服抗凝剂(NOACs)在急性冠脉综合征(ACS)中的应用日益受到关注。本文综述了NOACs在ACS中的基础理论、使用现状、临床研究及安全性问题。ACS的病理机制涉及动脉粥样硬化斑块破裂引发的血栓形成，而NOACs通过抑制凝血酶或Xa因子发挥抗凝作用，具有快速起效、无需频繁监测等优势。临床研究表明，NOACs在降低心血管事件风险方面具有一定效果，但可能增加出血风险，尤其在联合双抗血小板治疗时。个体化治疗方案需综合考虑患者年龄、肾功能及合并疾病等因素。尽管NOACs在老年和特殊人群中的安全性数据仍需进一步研究，但其便捷性和疗效为ACS患者的抗凝治疗提供了新选择。未来指南或将进一步优化NOACs的临床应用策略。
Abstract: Non-vitamin K antagonist oral anticoagulants (NOACs) have garnered increasing attention in the management of acute coronary syndrome (ACS). This review summarizes the foundational principles, current usage, clinical research, and safety concerns of NOACs in ACS. The pathophysiology of ACS involves thrombus formation due to atherosclerotic plaque rupture, and NOACs exert anticoagulant effects by inhibiting thrombin or factor Xa, offering advantages such as rapid onset and reduced monitoring requirements. Clinical studies indicate that NOACs may reduce cardiovascular events but could increase bleeding risks, particularly when combined with dual antiplatelet therapy. Personalized treatment plans should account for factors like age, renal function, and comorbidities. While safety data in elderly and special populations remain limited, the convenience and efficacy of NOACs provide a promising alternative for ACS patients. Future guidelines may further refine the clinical application of NOACs.
文章引用：潘港, 黄诗豪. 非维生素K拮抗口服抗凝剂在急性冠脉综合征中的应用[J]. 临床医学进展, 2025, 15(7): 393-398. https://doi.org/10.12677/acm.2025.1572001

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