{"id":43892,"date":"2024-11-20T05:10:41","date_gmt":"2024-11-20T05:10:41","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=43892"},"modified":"2024-11-20T05:10:41","modified_gmt":"2024-11-20T05:10:41","slug":"%e8%84%91%e6%a2%97%e6%b2%bb%e7%96%97%e6%8a%97%e6%9d%bfor%e6%8a%97%e5%87%9d%ef%bc%9f%e7%a5%9e%e5%86%85%e5%8c%bb%e7%94%9f%ef%bc%9a%e6%8e%8c%e6%8f%a1%e8%bf%993%e7%82%b9%e5%b0%b1%e5%a4%9f%e4%ba%86","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=43892","title":{"rendered":"\u8111\u6897\u6cbb\u7597\u6297\u677for\u6297\u51dd\uff1f\u795e\u5185\u533b\u751f\uff1a\u638c\u63e1\u8fd93\u70b9\u5c31\u591f\u4e86\uff01"},"content":{"rendered":"<p>                                        *\u4ec5\u4f9b\u533b\u5b66\u4e13\u4e1a\u4eba\u58eb\u9605\u8bfb\u53c2\u8003<\/p>\n<p>\u770b\u8fd9\u7bc7\u6587\u7ae0\u5c31\u77e5\u9053\u7b54\u6848\u4e86~<\/p>\n<p>\u64b0\u6587&nbsp;| 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&nbsp; &nbsp; &nbsp; &nbsp; &nbsp;\u7b26\u5408\u6297\u677f\u548c\u6297\u51dd\u9002\u5e94\u75c7\u7684\u4eba\u90fd\u8981\u4e00\u8d77\u8054\u7528\u5417\uff1f\u8be5\u6307\u5357\u63d0\u51fa\u4ee5\u4e0b\u5efa\u8bae\uff1a<\/p>\n<p>\u6307\u5357\u5efa\u8bae;<\/p>\n<ul>\n<li>\u9700\u8981\u7efc\u5408\u83b7\u76ca\u3001\u98ce\u9669\u53ca\u60a3\u8005\u610f\u613f\u3002<\/li>\n<li>\u5fc3\u8840\u7ba1\u75be\u75c5\u7684\u4e8c\u7ea7\u9884\u9632\uff1a\u63a8\u8350\u6297\u8840\u5c0f\u677f\u836f\u7269\u7528\u4e8e\u4e8c\u7ea7\u9884\u9632\u3002<\/li>\n<li>\u5982\u679c\u60a3\u8005\u8fd8\u6709\u6297\u51dd\u6307\u5f81\uff0c\u5efa\u8bae\u6297\u51dd\u5355\u836f\u6cbb\u7597\uff0c\u9664\u975e\u60a3\u8005\u5c5e\u4e8e\u8840\u6813\u4e8b\u4ef6\u201c\u9ad8\u98ce\u9669\u201d\uff0c\u53ef\u4ee5\u8003\u8651\u8054\u5408\u963f\u53f8\u5339\u6797\u6216\u6c2f\u5421\u683c\u96f7\u3002<\/li>\n<\/ul>\n<p>\u5982\u679c\u8981\u8054\u7528\u6709\u4ee5\u4e0b\u51e0\u70b9\u6ce8\u610f\u4e8b\u9879\u3002<\/p>\n<p>\u8054\u7528\u6ce8\u610f\u4e8b\u9879\uff1a<\/p>\n<p>\uff081\uff09\u5982\u679c\u8981\u8054\u7528\uff0c\u6297\u677f\u836f\u63a8\u8350\u963f\u53f8\u5339\u6797\u800c\u4e0d\u662f\u6c2f\u5421\u683c\u96f7\u3002<\/p>\n<p>\uff08\u4f5c\u8005\uff1a\u8fd9\u662f\u6b27\u7f8e\u4eba\u7fa4\u8bc1\u636e\uff0c\u4e2d\u56fd\u4eba\u7fa4\u4e0d\u5e94\u7167\u642c\uff0c\u8fd8\u662f\u5728\u57fa\u56e0\u68c0\u6d4b\u6307\u5bfc\u4e0b\u51b3\u7b56\u66f4\u597d\uff09<\/p>\n<p>\uff082\uff09\u5982\u679c\u8981\u8054\u7528\uff0c\u53ef\u4ee5\u5c06NOAC\u7684\u5242\u91cf\u4e0b\u8c03\u6216\u8005\u534e\u6cd5\u6797INR\u63a7\u5236\u57282-2.5\u3002\uff083\uff09\u8003\u8651\u60a3\u8005\u662f\u5426\u8054\u7528\u4e86\u5176\u5b83\u53ef\u80fd\u589e\u52a0\u51fa\u8840\u98ce\u9669\u7684\u836f\u7269\uff0c\u975e\u753e\u4f53\u7c7b\u6297\u708e\u836f\u3002\uff084\uff09\u8003\u8651\u52a0\u7528\u62a4\u80c3\u836f\u7269\uff08\u5982\u8d28\u5b50\u6cf5\u6291\u5236\u5242\uff09\u964d\u4f4e\u80c3\u51fa\u8840\u98ce\u9669\u3002\uff085\uff09\u540c\u60a3\u8005\u5145\u5206\u8ba8\u8bba\u6536\u76ca-\u98ce\u9669\uff08\u5145\u5206\u5229\u7528CHA2DS2-VASc and HAS-BLED scores\uff09\uff086\uff09\u5bc6\u5207\u968f\u8bbf\uff0c\u968f\u65f6\u8c03\u6574\u65b9\u6848\u30022.\u300a\u4e2d\u56fd\u5fc3\u623f\u98a4\u52a8\u60a3\u8005\u5352\u4e2d\u9884\u9632\u89c4\u83032017\u300b\u623f\u98a4\u60a3\u8005\u53d1\u751f\u5352\u4e2d\uff08\u672a\u8bf4\u660e\u75c5\u56e0\u662f\u52a8\u8109\u786c\u5316\u6216\u6813\u585e\uff09\u540e\u542f\u7528\u6297\u51dd\u836f\u7684\u65f6\u673a\u53d6\u51b3\u4e8e\u8111\u5352\u4e2d\u7684\u4e25\u91cd\u6027\uff0c\u63a8\u8350\u91c7\u7528\u201c1-3-6-12\u5929\u539f\u5219\u201d\u3002\u5177\u4f53\u8bf4\u6765\uff1a<\/p>\n<p>\uff081\uff09 TIA\u60a3\u8005\uff0c\u7b2c1\u5929\u65f6\u542f\u7528\u6297\u51dd\u836f\uff1b<\/p>\n<p>\uff082\uff09&nbsp;\u8f7b\u5ea6\u8111\u5352\u4e2d\uff08NIHSS&lt;8\u5206\uff09\u60a3\u8005\uff0c\u7b2c3\u5929\u542f\u7528\u6297\u51dd\u836f\uff1b\uff083\uff09&nbsp;\u4e2d\u5ea6\u8111\u5352\u4e2d\uff08NIHSS 8-15\u5206\uff09\u60a3\u8005\uff0c\u7b2c6\u5929\u5f71\u50cf\u5b66\uff08CT\u6216MRI\uff09\u8bc4\u4f30\u672a\u89c1\u51fa\u8840\u8f6c\u5316\u65f6\uff0c\u542f\u7528\u6297\u51dd\u836f\uff1b\uff084\uff09&nbsp;\u91cd\u5ea6\u8111\u5352\u4e2d\uff08NIHSS&gt;16\u5206\uff09\u60a3\u8005\uff0c\u7b2c12\u5929\u5f71\u50cf\u5b66\uff08CT\u6216MRI\uff09\u8bc4\u4f30\u672a\u89c1\u51fa\u8840\u8f6c\u5316\u65f6\uff0c\u542f\u7528\u6297\u51dd\u836f\u30023.\u300a2021\u7248AHA\/ASA\u6307\u5357\u300b\uff081\uff09\u5173\u4e8e\u623f\u98a4\u60a3\u8005\u53d1\u751f\u8111\u5352\u4e2d\u7684\u6025\u6027\u671f\u6cbb\u7597<\/p>\n<ul>\n<li>\u5bf9\u4e8eTIA\u5408\u5e76\u975e\u74e3\u819c\u6027\u623f\u98a4\u60a3\u8005\uff0c\u7acb\u5373\u542f\u52a8\u6297\u51dd\u6cbb\u7597\uff0c\u4ee5\u51cf\u5c11\u5352\u4e2d\u590d\u53d1\u98ce\u9669\u662f\u5408\u7406\u7684\u3002<\/li>\n<li>\u5bf9\u4e8e\u591a\u6570\u7684\u5408\u5e76\u623f\u98a4\u5e76\u4e14\u51fa\u8840\u8f6c\u5316\u4f4e\u98ce\u9669\u7684\u5352\u4e2d\u60a3\u8005\uff0c\u5728\u53d1\u75c5\u540e2\uff5e14\u5929\u518d\u542f\u52a8\u6297\u51dd\u6cbb\u6765\u51cf\u5c11\u5352\u4e2d\u590d\u53d1\u98ce\u9669\u662f\u5408\u7406\u7684\u3002<\/li>\n<li>\u5bf9\u4e8e\u8111\u6897\u6b7b\u51fa\u8840\u8f6c\u5316\u9ad8\u98ce\u9669\u7684\u5352\u4e2d\u60a3\u8005\uff0c\u53ef\u4ee5\u63a8\u8fdf\u5230\u53d1\u75c5\u540e14\u5929\u518d\u542f\u52a8\u6297\u51dd\u6cbb\u7597\uff0c\u4ee5\u51cf\u5c11\u8111\u51fa\u8840\u98ce\u9669\u3002<\/li>\n<\/ul>\n<p>\uff082\uff09\u5982\u4f55\u9009\u62e9\u6297\u51dd\u836f\u7269\uff1f2021\u7248AHA\/ASA\u6307\u5357\u63a8\u8350\uff1a\u5bf9\u4e8e\u5408\u5e76\u975e\u74e3\u819c\u6027\u5fc3\u623f\u98a4\u52a8\u7684\u7f3a\u8840\u6027\u5352\u4e2d\u6216 TIA 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\u6291\u5236\u5242\uff09\uff0c\u957f\u671f\u6cbb\u7597\u91c7\u7528\u6297\u51dd\u3002\uff08\u4ee5\u4e0a\u5904\u7406\u4ec5\u4ee3\u8868\u4f5c\u8005\u4e2a\u4eba\u610f\u89c1\uff09\u4e13\u5bb6\u7b80\u4ecb<\/p>\n<p>\u53c2\u8003\u6587\u732e\uff1a<\/p>\n<p>[1]Mega JL, Simon T. Pharmacology of antithrombotic drugs: an assessment of oral antiplatelet and anticoagulant treatments. Lancet. 2015;386(9990):281-91.[2]Floyd CN, Ferro A. Indications for anticoagulant and antiplatelet combined therapy. BMJ. 2017;359:j3782.[3]Eikelboom JW, Hirsh J. Combined antiplatelet and anticoagulant therapy: clinical benefits and risks. J Thromb Haemost. 2007;5 Suppl 1:255-63.[4]Benz AP, Johansson I, Dewilde WJM, Lopes RD, Mehran R, Sartori S, et al. Antiplatelet therapy in patients with atrial fibrillation: a systematic review and meta-analysis of randomized trials. Eur Heart J Cardiovasc Pharmacother. 2022;8(7):648-59.[5]De Schryver EL, Algra A, Kappelle LJ, van Gijn J, Koudstaal PJ. Vitamin K antagonists versus antiplatelet therapy after transient ischaemic attack or minor ischaemic stroke of presumed arterial origin. Cochrane Database Syst Rev. 2012;2012(9):CD001342.[6]Saxena R, Koudstaal P. Anticoagulants versus antiplatelet therapy for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischemic attack. Cochrane Database Syst Rev. 2004(4):CD000187.[7]Lopes RD, Hong H, Harskamp RE, Bhatt DL, Mehran R, Cannon CP, et al. Optimal Antithrombotic Regimens for Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: An Updated Network Meta-analysis. JAMA Cardiol. 2020;5(5):582-9.[8]Paikin JS, Wright DS, Eikelboom JW. Effectiveness and safety of combined antiplatelet and anticoagulant therapy: a critical review of the evidence from randomized controlled trials. 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