摘要： 心房颤动是急性缺血性卒中的独立危险因素，由其引起的缺血性卒中约占全部缺血性卒中的20%；与心房颤动相关的危险因素包括高龄（≥ 75 岁）、高血压、糖尿病、近期心力衰竭、缺血性卒中或短暂性脑缺血发作病史，风险评价体系包括CHADS₂ 和CHA₂DS₂-VAS_C 评分系统。风险评价体系的建立有利于评价脑卒中风险、决定采取何种治疗措施。预防性治疗原则为高度和中度风险行抗凝治疗、低度风险行抗血小板治疗或不治疗。华法林目前仍是主要抗凝药物，新型口服抗凝药虽具有脑卒中发生率和出血率低、无需监测等优点，但缺乏多中心大样本随机对照试验的验证。

关键词: 卒中, 心房颤动, 血小板聚集抑制剂, 抗凝药, 综述

Abstract: Atrial fibrillation (AF) is the independent risk factor for acute ischemic stroke. AF-related ischemic stroke account for 20% of total ischemic stroke. Risk factors include old age (≥ 75 years), hypertension, diabetes mellitus, recent heart failure, ischemic stroke and transient ischemic attack (TIA) history. Risk evaluation system mainly contains CHADS₂ and CHA₂DS₂-VAS_c. The establishment of risk evaluation system is favorable for evaluating the future risk of stroke, and deciding to take which kind of treatment measures: anticoagulant therapy for high, moderate risk; anti-platelet aggregation treatment or no treatment for low risk. Warfarin is still the main anticoagulant drug at present. New oral anticoagulants (NOACs) have advantages such as low incidence of stroke, low bleeding rate, no need to monitor, however, they are lack of validation from multicenter, large sample randomized controlled trials.

Key words: Stroke, Atrial fibrillation, Platelet aggregation inhibitors, Anticoagulants, Review