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2015长城会：张萍教授谈房颤抗凝治疗新进展

2015-11-02 北京清华长庚医院 张萍 中国医学论坛报

张萍教授房颤抗凝治疗新进展
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第二十六届长城国际心脏病学会议 第九届北京五洲国际心血管病会议2015 亚太心脏大会暨国际心血管病预防与康复会议2015 抗凝作为房颤治疗的基本措施，受到了医生和患者的极大关注。该领域的研究层出不穷，指南变更与时俱进。其进展主要有以下几个方面： 1.欧美权威学会对于房颤卒中风险评分系统达成一致观点，均接受应用CHA2DS2-VASc评分评估房颤患者血栓栓塞事件风

第二十六届长城国际心脏病学会议

第九届北京五洲国际心血管病会议2015

亚太心脏大会暨国际心血管病预防与康复会议2015

抗凝作为房颤治疗的基本措施，受到了医生和患者的极大关注。该领域的研究层出不穷，指南变更与时俱进。其进展主要有以下几个方面：

1.欧美权威学会对于房颤卒中风险评分系统达成一致观点，均接受应用CHA2DS2-VASc评分评估房颤患者血栓栓塞事件风险。

2.新型口服抗凝药(NOACs)在房颤抗凝治疗中的地位不断提升，可作为CHA2DS2-VASc 评分>2 分患者的一线治疗，但在NOACs 的使用中应强调注意事项，对于瓣膜性房颤和急性冠脉综合征(ACS)伴发房颤患者，由于缺乏充分的循证医学证据暂不推荐使用NOACs。

3.抗血小板药物的应用地位逐渐下降。

4.对于因出血事件或接受外科或介入治疗需要暂停抗凝治疗的患者，建议综合患者血栓事件风险、手术严重程度和围术期出血风险，来考虑中断抗凝治疗的时间和重新启动抗凝治疗的时机。对于应用肝素作为桥接手段，由于证据基础较弱，不进行强烈推荐。

5.左心耳封堵作为房颤抗凝的手段，已获得较为正面的循证依据，应该可以作为一项房颤抗栓治疗的适宜技术。

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    2016-04-18 xiongke020

    #房颤抗凝#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1694810, encodeId=f6451694810b9, content=<a href='/topic/show?id=a7385426313' target=_blank style='color:#2F92EE;'>#房颤抗凝#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54263, encryptionId=a7385426313, topicName=房颤抗凝)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8df129768056, createdName=xiongke020, createdTime=Mon Apr 18 00:56:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2080752, encodeId=e47b2080e52cf, content=<a href='/topic/show?id=d1a150001b0' target=_blank style='color:#2F92EE;'>#张萍教授#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50001, encryptionId=d1a150001b0, topicName=张萍教授)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87d405, createdName=Homburg, createdTime=Fri Apr 01 18:56:00 CST 2016, time=2016-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322730, encodeId=977b1322e3000, content=<a href='/topic/show?id=355b96891fe' target=_blank style='color:#2F92EE;'>#长城会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96891, encryptionId=355b96891fe, topicName=长城会)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef33504, createdName=wsusan1966, createdTime=Tue Nov 03 23:56:00 CST 2015, time=2015-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42225, encodeId=fa1d4222563, content=最新指南, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ded71629504, createdName=nizongzan, createdTime=Mon Nov 02 12:52:00 CST 2015, time=2015-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42226, encodeId=bac24222625, content=学到老活到老, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ded71629504, createdName=nizongzan, createdTime=Mon Nov 02 12:52:00 CST 2015, time=2015-11-02, status=1, ipAttribution=)]
    2016-04-01 Homburg

    #张萍教授#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1694810, encodeId=f6451694810b9, content=<a href='/topic/show?id=a7385426313' target=_blank style='color:#2F92EE;'>#房颤抗凝#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54263, encryptionId=a7385426313, topicName=房颤抗凝)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8df129768056, createdName=xiongke020, createdTime=Mon Apr 18 00:56:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2080752, encodeId=e47b2080e52cf, content=<a href='/topic/show?id=d1a150001b0' target=_blank style='color:#2F92EE;'>#张萍教授#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50001, encryptionId=d1a150001b0, topicName=张萍教授)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87d405, createdName=Homburg, createdTime=Fri Apr 01 18:56:00 CST 2016, time=2016-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322730, encodeId=977b1322e3000, content=<a href='/topic/show?id=355b96891fe' target=_blank style='color:#2F92EE;'>#长城会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96891, encryptionId=355b96891fe, topicName=长城会)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef33504, createdName=wsusan1966, createdTime=Tue Nov 03 23:56:00 CST 2015, time=2015-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42225, encodeId=fa1d4222563, content=最新指南, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ded71629504, createdName=nizongzan, createdTime=Mon Nov 02 12:52:00 CST 2015, time=2015-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42226, encodeId=bac24222625, content=学到老活到老, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ded71629504, createdName=nizongzan, createdTime=Mon Nov 02 12:52:00 CST 2015, time=2015-11-02, status=1, ipAttribution=)]
    2015-11-03 wsusan1966

    #长城会#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1694810, encodeId=f6451694810b9, content=<a href='/topic/show?id=a7385426313' target=_blank style='color:#2F92EE;'>#房颤抗凝#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54263, encryptionId=a7385426313, topicName=房颤抗凝)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8df129768056, createdName=xiongke020, createdTime=Mon Apr 18 00:56:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2080752, encodeId=e47b2080e52cf, content=<a href='/topic/show?id=d1a150001b0' target=_blank style='color:#2F92EE;'>#张萍教授#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50001, encryptionId=d1a150001b0, topicName=张萍教授)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87d405, createdName=Homburg, createdTime=Fri Apr 01 18:56:00 CST 2016, time=2016-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322730, encodeId=977b1322e3000, content=<a href='/topic/show?id=355b96891fe' target=_blank style='color:#2F92EE;'>#长城会#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96891, encryptionId=355b96891fe, topicName=长城会)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef33504, createdName=wsusan1966, createdTime=Tue Nov 03 23:56:00 CST 2015, time=2015-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42225, encodeId=fa1d4222563, content=最新指南, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ded71629504, createdName=nizongzan, createdTime=Mon Nov 02 12:52:00 CST 2015, time=2015-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42226, encodeId=bac24222625, content=学到老活到老, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ded71629504, createdName=nizongzan, createdTime=Mon Nov 02 12:52:00 CST 2015, time=2015-11-02, status=1, ipAttribution=)]
    2015-11-02 nizongzan

    最新指南

    0

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    2015-11-02 nizongzan

    学到老活到老

    0

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