中国现代神经疾病杂志 ›› 2024, Vol. 24 ›› Issue (2): 84-90. doi: 10.3969/j.issn.1672-6731.2024.02.005

• 泛血管医学时代:脑心共病诊断与治疗 • 上一篇    下一篇

2 非瓣膜性房颤并急性缺血性卒中抗凝治疗时机

卢凤民*(), 吴冬燕   

  1. 300222 天津大学胸科医院心内科 天津市心血管病研究所 天津市心血管急危重症重点实验室
  • 收稿日期:2024-01-09 出版日期:2024-02-25 发布日期:2024-02-27
  • 通讯作者: 卢凤民
  • 基金资助:
    天津市卫生计生委科技攻关项目(16KG134)

Anticoagulation initiation after non-valvular atrial fibrillation with acute ischemic stroke

Feng-min LU*(), Dong-yan WU   

  1. Department of Cardiology; Tianjin Institute of Cardiovascular Disease; Tianjin Key Laboratory of Cardiovascular Emergency and Critical Care, Chest Hospital, Tianjin University, Tianjin 300222, China
  • Received:2024-01-09 Online:2024-02-25 Published:2024-02-27
  • Contact: Feng-min LU
  • Supported by:
    Key Technology Research and Development Program of Tianjin Health and Family Planning Commission(16KG134)

摘要:

抗凝治疗是非瓣膜性房颤合并急性缺血性卒中的脑卒中二级预防重要策略,但其最佳启动时机尚无一致性意见。近年的循证医学证据发现急性缺血性卒中后早期启动抗凝治疗较延期抗凝治疗更具优势。本文拟对非瓣膜性房颤合并急性缺血性卒中患者抗凝治疗的启动时机进行综述,以期在平衡减少脑卒中复发与降低出血性转化风险的基础上,为此类患者选择更合理的抗凝治疗启动时机提供参考。

关键词: 心房颤动, 缺血性卒中, 抗凝药, 综述

Abstract:

Anticoagulant treatment is an important strategy for secondary stroke prevention in non-valvular atrial fibrillation and acute ischemic stroke patients. However, the optimal timing for anticoagulation initiation after acute ischemic stroke has remained uncertain. In recent years, new clinical evidence has identified the benefit of early anticoagulation initiation rather than delayed anticoagulation initiation after acute ischemic stroke. This article reviews the literature on the topic of anticoagulation initiation in non-valvular atrial fibrillation with acute ischemic stroke patients. It helps physicians making decision to initiate anticoagulation at a more reasonable time point after balancing the risk of stroke recurrence and hemorrhagic transformation.

Key words: Atrial fibrillation, Ischemic stroke, Anticoagulants, Review