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房颤合并慢性肾病的抗凝策略

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房颤(Atrial fibrillation， AF)和慢性肾脏疾病( chronic kidney disease ，CKD)的多种致病因素常存在共通性，如高血压、糖尿病和冠状动脉疾病。当不合并CKD时，对房颤患者开展抗凝治疗是毋庸置疑的，但此做法不适用于房颤合并晚期CKD的患者群（advanced CKD）。随着CKD患者肾功能的下降，缺血性卒中和出血的危险逐渐增加，使抗凝治疗趋向复杂。现存随机对照试验尚不能得出可明确辅助临床决策的指南性意见，而观察性研究的结果相互矛盾。在最新JACC综述“Anticoagulation in Concomitant Chronic Kidney Disease and Atrial Fibrillation: JACC Review Topic of the Week”中,作者概述了相关病理生理学机制,总结CKD合并AF的抗凝策略及研究进展， 并就如何在这些患者中使用口服抗凝给出建议。

该文核心要点可参阅CBSMD文献导读“Anticoagulation in Concomitant CKD and AF”。



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