直接口服抗凝药在静脉血栓栓塞特殊人群中的临床应用

【关键词】抗凝药；静脉血栓栓塞；直接口服抗凝药；特殊人群；临床应用；综述【中图分类号】R973.2R543【文献标识码】A DOI：10.12114/j.issn.1007-9572.2024.0541

【Abstract】Direct oral anticoagulants（DOACs） have been approved for the treatment and secondary prevention of venous thromboembolism（VTE），andhave achieved stableappication among clinicians inrecent years，with an expanding scope ofuse.Althoughroutine monitoring isnotrequiredforfixed-doseDOACs，inthecontextofspecialpatient populations presenting with factorssuchasextremebody weight，impaired hepaticorrenal function，advancedage，pregnancy and lactation，andmultiplecomorbidities，DOACsitroduce therapeuticuncertainties，potentiallnecessitatingdoseadjustentor exclusionfromuse.Insuchcases，considerationshouldbe giventotheuseof raditionalanticoagulantssuchasheparinorvitamin Kantagonist（VKA）.Increasing numbers of studies have been conducted toassessthe safetyand efectivenessof DOACs in thesespecialVTEpatientpopulationsacrossawiderangeofsetings.Thisreviewconsolidatesandanalyzesthelatestresearch progress on DOACs in these special patient populations，providing evidenceand insights formorerational useof DOACs in clinical practice and optimizing anticoagulation strategies.

【Key words】 Anticoagulants；Venous thromboembolism；Direct oral anticoagulants；Special population; [reatment；Review

维生素K拮抗剂（vitaminKantagonist，VKA）、低分子量肝素（lowmolecularweight heparin，LMWH）作为传统抗凝药物，存在用药不便、安全区间窄、容易与其他药物食物发生相互作用、出血风险较高等不足。（剩余16507字）