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中国临床药理学与治疗学 ›› 2023, Vol. 28 ›› Issue (7): 809-817.doi: 10.12092/j.issn.1009-2501.2023.07.012

• 综述与讲座 • 上一篇    下一篇

利伐沙班血药浓度监测的研究进展

余巧玲1,2,翟葳葳1,2,刘  平1,2,邱  博2,吴惠珍1,2   

  1. 1河北医科大学研究生院,石家庄  050017,河北;2河北省人民医院药学部,石家庄  050051,河北
  • 收稿日期:2023-03-07 修回日期:2023-06-10 出版日期:2023-07-26 发布日期:2023-07-31
  • 通讯作者: 吴惠珍,女,硕士,硕士生导师,主任药师,主要从事临床药学的研究。 E-mail: 13582005982@163.com
  • 作者简介:余巧玲,女,硕士在读,主要从事临床药学的研究。 E-mail: yql2799340092@163.com
  • 基金资助:
    河北省自然科学基金资助项目(H2020307020)

Research progress in plasma concentration monitoring of rivaroxaban

YU Qiaoling1,2, ZHAI Weiwei1,2, LIU Ping1,2, QIU Bo2, WU Huizhen1,2   

  1. 1 Graduate School of Hebei Medical University, Shijiazhuang 050017, Hebei, China; 2 Departmentof Pharmacy, Hebei General Hospital, Shijiazhuang 050051, Hebei, China
  • Received:2023-03-07 Revised:2023-06-10 Online:2023-07-26 Published:2023-07-31

摘要:

利伐沙班是目前临床上广泛使用的新型口服抗凝药,具有可预测的药代动力学和药效学特征,药物-药物和食物-药物相互作用较少,常以固定剂量给药,无需常规监测凝血参数。但在某些紧急临床情况下,如出血、急性脑卒中、急性肾损伤、紧急手术前和怀疑药物蓄积中毒等,有必要监测患者体内利伐沙班血药浓度。现有研究表明,利伐沙班血药浓度范围广泛,个体差异性大,存在临床用药风险。监测利伐沙班血药浓度,探索其药物治疗窗,可辅助临床个体化用药和安全用药。本文旨在概述利伐沙班血药浓度的影响因素、监测方法、治疗窗研究进展及相关病例报道,以期为临床上利伐沙班合理用药提供参考。

关键词: 利伐沙班, 血药浓度监测, 新型口服抗凝药

Abstract:

Rivaroxaban, a novel oral anticoagulant drug, is widely prescribed in clinical practice. Rivaroxaban offers predictable pharmacokinetic and pharmacodynamic properties, a lowprobability of drug-drug and food-drug interactions. Compared with warfarin, rivaroxaban does not require continuous therapeutic monitoring and can be administered in fixed doses.However,in certain emergency clinical situations, such as bleeding, acute stroke, acute kidney injury, prior to urgent surgery and in the suspected accumulation of durg, plasma concentration monitoring of rivaroxaban is necessary and important for patients. Existing studies proved that there were significant individual variability and wide range in the plasma rivaroxaban concentration, which increased the risk of clinical use. Therefore, Data in the degree of rivaroxaban concentration may provide recommendations for the clinical application to promote medication safety and individuality in the future. This article collected the latest literatures and case reports related to research progress of rivaroxaban plasma concentration monitoring, and Summarized influencing factors, monitoring methods, so as to provide a basis for further study on rational use of rivaroxaban in clinical.

Key words: rivaroxaban, therapy drug monitoring, new oral anticoagulants

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