抗凝药物在急性肺栓塞治疗中的应用进展

抗凝是治疗急性肺栓塞(APE)的关键，一旦确诊APE，应立即开始抗凝治疗，除非存在明显的禁忌证。传统治疗APE方案包括初始胃肠外抗凝治疗（普通肝素或低分子肝素），随后长期口服维生素K拮抗剂(VKAs)。尽管传统治疗方案能有效减少静脉血栓栓塞（VTE）复发，但长期服用VKAs存在局限性，因此接受长期抗凝治疗的肺栓塞患者，目前需要一种无需实验室监测和剂量调整的口服抗凝剂，这就使新型口服抗凝剂应运而生。

Progress of anticoagulants in treatment of acute pulmonary embolism

Anticoagulation is the key to the treatment of acute pulmonary embolism (APE). Once the APE is diagnosed, anticoagulant therapy should begin immediately unless there is obvious contraindication. Traditional treatment includes initial parenteral anticoagulants (heparin or low-molecular weight heparin) along with vitamin K antagonists (VKAs). Although traditional treatment can effectively reduce the recurrence of venous thromboembolism (VTE), long-term use of vitamin K antagonists has some limitations. PE patients treated with a long-term anticoagulation therapy need some type of oral anticoagulants without laboratory monitoring and dose adjustment. This needs calls for some new oral anticoagulants (NOACs) for long-term anticoagulation therapy.