口服抗凝药在肝病患者中应用的研究进展

摘要

肝病患者栓塞和出血风险均增加,当合并静脉血栓栓塞疾病时,尚不明确最佳的抗凝方案.而目前批准的口服抗凝药物都不同程度经肝脏代谢和消除,肝功能受损可能导致出血风险增加,使得抗凝治疗更加复杂.现对肝病患者的出血与血栓风险,以及口服抗凝药在肝病患者应用的临床研究进展进行总结,以期为需要抗凝治疗的肝病患者选用口服抗凝药提供证据.%Patients with liver disease are at an increased risk of both embolism and bleeding.The optimal anticoagulation strategy remains unclear when associated with venous thromboembolic disease.Moreover,currently approved oral anticoagulant drugs undergo metabolism and elimination in the liver with varying degrees of hepatic dysfunction.Thus,impaired liver function may lead to increased risk of bleeding,making anticoagulant therapy more intricate.This article summarizes the risk of bleeding and thrombosis in patients with liver disease,and the clinical research progress of oral anticoagulants in patients with liver disease to facilitate evidence for choosing oral anticoagulants therapy when required.