作者：崔咏诗，邓莉，彭礼飞

单位：

1.广东医科大学医学技术学院2.广东医科大学寄生虫学教研室

单位（英文）：

1.School of Medical Technology, Guangdong Medical University, Dongguan 523000, China2.Department of Parasitology, Guangdong Medical University, Zhanjiang 524023, China

关键词：

静脉血栓栓塞; 抗凝药; 凝血因子; 综述;

关键词（英文）：

Venous thromboembolism; Anticoagulants; Coagulation factors; Review

中图分类号：

DOI：

10.12114/j.issn.1008-5971.2023.00.109

基金项目：

国家自然科学基金青年科学基金项目（31101639）； 广东省科技发展专项资金项目（2017A010105022）；

摘要：

静脉血栓栓塞症（VTE）包括深静脉血栓形成（DVT）和肺血栓栓塞症（PTE），其是住院患者非预期死亡的重要原因，已构成医疗质量和患者安全的潜在风险，且近10年来其造成的疾病负担逐年增加。目前，抗凝治疗是防治VTE的关键措施，尽管直接口服抗凝药（DOACs）较传统抗凝药更有效、安全且便利，但仍无法平衡治疗期间的抗栓与出血风险，故寻找更安全的抗凝靶点是VTE抗凝药研发的重点。本文以抗凝靶点为切入点总结了VTE抗凝药的研究现状，即凝血酶和凝血因子Ⅹa抑制剂虽已广泛用于临床，但适用人群受限，组织因子/凝血因子Ⅶa复合物、凝血因子Ⅷa及凝血因子Ⅸa抑制剂存在出血风险，凝血因子Ⅴa、凝血因子ⅩⅢa及凝血因子Ⅻa抑制剂的抗栓效果仍有待进一步评估，凝血因子Ⅺa可能是当前最有希望的抗凝靶点之一。

英文摘要：

Venous thromboembolism (VTE) , including deep venous thrombosis (DVT) and pulmonarythromboembolism (PTE) , is an important cause of unexpected death in hospitalized patients. It has become a potential risk tomedical quality and patient safety, and its disease burden has increased year by year in the past 10 years. At present, anticoagulanttherapy is the key measure to prevent and treat VTE. Although direct oral anticoagulants (DOACs) are more effective, safe andconvenient than traditional anticoagulants, they still cannot balance the antithrombotic and risk of bleeding during the treatment.Therefore, finding safer anticoagulant targets is the focus of VTE anticoagulant drug development. In this paper, the research statusof VTE anticoagulants is summarized from the perspective of anticoagulant targets. Although thrombin and factor Ⅹa inhibitorshave been widely used in clinical practice, but their application groups are limited. Tissue factor/factor Ⅶa compound, factor Ⅷaand factor Ⅸa inhibitors have the bleeding risk. The antithrombotic effects of factor Ⅴa, factor ⅩⅢa and factor Ⅻa inhibitors stillneed to be further evaluated. Factor Ⅺa may be one of the most promising anticoagulant targets.

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