心房颤动非维生素K拮抗剂口服抗凝药物抗凝出血风险评估的研究进展

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中图分类号：R541.75 文献标识码：A 文章编号：1000-503X（2025）03-0452-10

DOI：10.3881/j. issn.1000-503X.16331

Research Progress in Bleeding Risk Assessment of Non- Vitamin K Antagonist Oral Anticoagulant in Atrial Fibrillation

YU Chao 1 ，ZHOU Wei'，WANG Tao’，ZHU Lingjuan¹，BAO Huihui 1，2 ，CHENG Xiaoshu 1，2 1 Center for Prevention and Treatment of Cardiovascular Diseases， 2 Department of Cardiology ， TheSecond Affiliated Hospital of Nanchang University，Nanchang 33ooO6，China

brresponding author：CHENG Xiaoshu Tel：0791-86296098，E-mail：xiaoshumenfanl26@163.cor

ABSTRACT：The introduction of non- vitamin K antagonist oral anticoagulant （NOAC）into clinical use heraldsanewage for anticoagulation therapy in patientswith atrial fibrilltion（AF）.However，anticoagulationrelated bleeding is currently a major challenge in the anticoagulation process.Assessing the risk of anticoagulationrelated bleeding isan important part forthe management of patients with AF.Clinical risk factor scores have moderateabilitytopredicttheriskofanticoagulation-relatedbleeding.Toimprovetheanticoagulationsafetyof NOACs，aditional clinical and biological markers and genetic polymorphisms should be considered to enhance thepredictive capability for anticoagulation-related bleeding.This review summarizes the challenges in the management of anticoagulation therapy，with emphases on the bleeding risk scores，biomarkers，clinical indicators， and genetic loci currently used to guide the risk assessment of anticoagulation-related bleeding inAF patients. This review is expected to provide research insightsand reference frameworks for predictingand evaluating the bleeding risk associated with NOACs.

ActaAcadMedSin，2025，47（3）：452-461

心房颤动（atrialfibrillation，AF）是临床最常见的持续性心律失常，截至2019年，全球AF患者约为5970万例。（剩余25332字）