逆转达比加群酯抗凝活性的研究进展和处理建议

中国临床药理学与治疗学 ›› 2012, Vol. 17 ›› Issue (12): 1413-1418.

逆转达比加群酯抗凝活性的研究进展和处理建议

谭胜蓝¹, 周新民², 彭娟¹, 张伟¹, 刘昭前¹, 周宏灏¹, 李智¹

¹中南大学临床药理研究所,长沙 410078, 湖南;
²中南大学湘雅二医院胸心外科,长沙 410011,湖南

收稿日期:2012-08-17 修回日期:2012-09-20 发布日期:2012-12-31
通讯作者: 李智,通信作者,男,副教授,主要从事遗传药理学和临床药理学研究。Tel: 0731-84805380 E-mail: lizhi489@163.com
作者简介:谭胜蓝,女,博士研究生,主要从事遗传药理学和临床药理学研究。Tel: 0731-84805380 　E-mail: shenglantan@gmail.com
基金资助:
国家高技术研究发展计划(863计划)(2012AA02A517, 2012AA02A518); 教育部跨世纪优秀人才培养计划(NCET-10-0843); 湖南省科研基金(11K073,12JJ7006)

Reversal of the anticoagulant effect of dabigatran etexilate

TAN Sheng-lan¹, ZHOU Xin-min², PENG Juan¹, ZHANG Wei¹, LIU Zhao-qian¹, ZHOU Hong-hao¹, LI Zhi¹

¹Institute of Clinical Pharmacology, Central South University, Changsha 410078,Hunan,Cnina;
²Department of Cardio-thoracic Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, Hunan,China

Received:2012-08-17 Revised:2012-09-20 Published:2012-12-31

摘要/Abstract

摘要： 达比加群酯是一种直接抑制凝血酶的新型口服抗凝药,具有较好的抗凝疗效和安全性,出血是其最常见的不良反应,发生率略低于或类似于华法林和依诺肝素。当服用达比加群酯的患者发生大出血,或者需进行手术或侵入性处理时,常须紧急逆转其抗凝活性。目前尚未研发出达比加群酯特异性解药,临床上应根据患者的出血部位和严重程度,进行综合治疗。监测凝血酶凝固时间(TT)和蛇静脉酶凝结时间(ECT)等指标有助于判断逆转达比加群酯活性的疗效。

关键词: 达比加群酯, 逆转, 抗凝, 出血

Abstract: Dabigatran etexilate is a new oral anticoagulant that acts as a direct thrombin inhibitor. Dabigatran etexilate generally shows good efficacy and safty, however, bleeding is the most common side effect which is slightly lower than or similar to that of warfarin or enoxaparin. In certain clinical situations including major bleeding and requirement of surgery or invasive procedure, clinicians will have to reverse the anticoagulant effect of dabigatran etexilate emergently. So far no antidote for dabigatran etexilate has been established.The management of bleeding resulting from dabigatran etexilate should be individualized based on the location and severity of the hemorrhage. Tests including thrombin clotting time (TT) and ecarin clotting time (ECT) will be helpful to determine the reversal of the anticoagulant effect of dabigatran etexilate.

Key words: Dabigatran etexilate, Reversal, Anticoagulant effect, Bleeding

中图分类号:

R973.2

谭胜蓝, 周新民, 彭娟, 张伟, 刘昭前, 周宏灏, 李智. 逆转达比加群酯抗凝活性的研究进展和处理建议[J]. 中国临床药理学与治疗学, 2012, 17(12): 1413-1418.

TAN Sheng-lan, ZHOU Xin-min, PENG Juan, ZHANG Wei, LIU Zhao-qian, ZHOU Hong-hao, LI Zhi. Reversal of the anticoagulant effect of dabigatran etexilate[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2012, 17(12): 1413-1418.

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