新型抗凝药物直接Xa因子抑制剂利伐沙班

抗凝药物在防治血栓事件中发挥重要作用，但传统的抗凝药物如肝素需胃肠道外给药，院外使用不便。口服抗凝药如华法林治疗安全窗窄，需经常监测凝血酶原时间，也给患者使用带来不便。新型口服抗凝剂利伐沙班是直接Xa因子抑制剂，具有使用方便、无需监测的优点。现有的循证医学证据表明其在防治血栓事件中安全、有效。本文就利伐沙班的临床研究进展作一介绍。

Novel anticoagulant, direct factor Xa inhibitor: Rivaroxaban

Anticoagulants are recommended for the prevention and treatment of a wide variety of thrombo-embolic events. Although existing anticoagulants are effective, their usage is limited by parenteral administration or the requirement for frequent monitoring and subsequent dose adjustment. Therefore, there is an urgent need for novel, oral agents with a predictable anticoagulant action. Because of its key position in the coagulation cascade and its limited roles outside of coagulation, Factor Xa has presented as an attractive target for novel anticoagulants. As a result, the past decade has witnessed an explosion of research into small-molecule, oral, direct Factor Xa inhibitors, and some are now in clinical development. Rivaroxaban is currently furthest ahead in its developmental program, having entered phase Ⅲ in 3 indications. It is hoped that, before long, these anticoagulants will allow us to enter an era of convenient, oral anticoagulation, without the need for regular monitoring or dose adjustment.