中国急性血栓性疾病抗栓治疗共识

doi:10.3969/j.issn.1002-1949.2019.06.001

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摘要急性血栓性疾病是临床常见的一大类急症，属于急性非创伤性血管急症的范畴；按照累及的血管系统分类可分为动脉系统血栓栓塞和静脉系统血栓栓塞，按照解剖器官分类可以分为头颈部血栓栓塞、胸部血栓栓塞、腹部血栓栓塞、肢体血栓栓塞等。动脉系统血栓栓塞表现为受累血管支配的相应器官缺血，甚至坏死，及时的血管再灌注治疗可以挽救相应器官，也直接影响患者的预后；静脉系统血栓栓塞包括肺栓塞和深静脉血栓（deep venous thrombosis，DVT），表现为受累静脉的回流障碍，DVT血栓脱落后表现为肺血管栓塞，重者可危及生命，需要在时间窗内给予再灌注治疗。目前国内外尚缺乏针对急性血栓性疾病抗栓治疗的共识或者指南。因此，中华医学会急诊医学分会和中国医药教育协会急诊医学分会组织相关领域专家组成共识编制组，共同编制了《中国急性血栓性疾病抗栓治疗共识》，旨在规范并提升临床医师对急性血栓疾病的诊断和抗栓治疗的实践能力，为进一步开展临床实践和相关研究提供指导意见。

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	中国医药教育协会急诊医学分会
	中华医学会急诊医学分会心脑血管学组
	急性血栓性疾病急诊专家共识组

通讯作者: 马青变，女，博士，主任医师，北京大学第三医院; 郑亚安，男，主任医师，北京大学第三医院；朱继红，男，博士，主任医师，北京大学人民医院; 陈玉国，男，博士，主任医师，山东大学齐鲁医院

引用本文:

中国医药教育协会急诊医学分会，中华医学会急诊医学分会心脑血管学组，急性血栓性疾病急诊专家共识组. 中国急性血栓性疾病抗栓治疗共识[J]. 中国急救医学, 2019, 39(6): 501-531.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2019.06.001 或 http://www.cnemergency.org.cn/CN/Y2019/V39/I6/501

［1］Yoo HH, Queluz TH, El Dib R. Anticoagulant treatment for subsegmental pulmonary embolism［J］. Cochrane Database Syst Rev, 2016,(1):CD010222.  ［2］Ponziani FR. What we should know about portal vein thrombosis in cirrhotic patients: A changing perspective［J］. World Journal of Gastroenterology, 2012, 18(36):5014-5020. ［3］Konstantinides SV, Torbicki A, Agnelli G, et al. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism［J］. Eur Heart J, 2014, 35(43):3033-3069.  ［4］中华医学会心血管病学分会肺血管病学组. 急性肺栓塞诊断与治疗中国专家共识(2015)［J］. 中华心血管病杂志, 2016, 44(3):197-211.  ［5］Kearon C, Akl EA, Ornelas J, et al. Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report［J］. Chest, 2016, 149(2):315-352.  ［6］Prasad V, Rho J, Cifu A. The diagnosis and treatment of pulmonary embolism: a metaphor for medicine in the evidence-based medicine era［J］. Arch Intern Med, 2012， 172(12):955-958.  ［7］Donato AA, Khoche S, Santora J, et al. Clinical outcomes in patients with isolated subsegmental pulmonary emboli diagnosed by multidetector CT pulmonary angiography［J］. Thromb Res, 2010, 126(4):e266-270. ［8］den Exter PL, van Es J, Klok FA, et al. Risk profile and clinical outcome of symptomatic subsegmental acute pulmonary embolism［J］. Blood, 2013, 122(7):1144-1149. ［9］Eldredge JB, Spyropoulos AC. Direct oral anticoagulants in the treatment of pulmonary embolism. Curr Med Res Opin, 2018, 34(1):131-140. 〖ZK)〗 ［10］Dentali F, Di Minno MND, Gianni M, et al. Non-vitamin K oral anticoagulants in patients with pulmonary embolism: a systematic review and meta-analysis of the literature［J］. Intern Emerg Med, 2015, 10(4):507-514.  ［11］Larsen TB, Nielsen PB, Skjoth F, et al. Non-vitamin K antagonist oral anticoagulants and the treatment of venous thromboembolism in cancer patients: a semi systematic review and meta-analysis of safety and efficacy outcomes［J］. PLoS One, 2014, 9(12):e114445.  ［12］Konigsbrugge O, Langer M, Hayde M, et al. Oral anticoagulation with rivaroxaban during pregnancy: a case report［J］. Thromb Haemost, 2014, 112(6):1323-1324.  ［13］Myers B, Neal R, Myers O, et al. Unplanned pregnancy on a direct oral anticoagulant (Rivaroxaban): A warning［J］. Obstet Med, 2016, 9(1):40-42.  ［14］陆艳辉, 李雅敏, 王静, 等. 新型口服抗凝药物——抗凝治疗新选择［J］. 中华急诊医学杂志, 2016, 25(8):989-996.  ［15］Burnett AE, Mahan CE, Vazquez SR, et al. Guidance for the practical management of the direct oral anticoagulants (DOACs) in VTE treatment［J］. J Thromb Thrombolysis, 2016, 41(1):206-232.  ［16］Lee AY, Bauersachs R, Janas MS, et al. CATCH: a randomised clinical trial comparing long-term tinzaparin versus warfarin for treatment of acute venous thromboembolism in cancer patients［J］. BMC Cancer, 2013, 13:284. ［17］Lee AYY, Kamphuisen PW, Meyer G, et al. Tinzaparin vs Warfarin for Treatment of Acute Venous Thromboembolism in Patients With Active Cancer: A Randomized Clinical Trial［J］. JAMA, 2015, 314(7):677-686. ［18］Couturaud F, Sanchez O, Pernod G, et al. Six Months vs Extended Oral Anticoagulation After a First Episode of Pulmonary Embolism: The PADIS-PE Randomized Clinical Trial［J］. JAMA, 2015, 314(1):31-40.  ［19］Gao GY, Yang P, Liu M, et al. Thrombolysis for acute intermediate-risk pulmonary embolism: A meta-analysis［J］. Thromb Res, 2015, 136(5):932-937.  ［20］Riera-Mestre A, Becattini C, Giustozzi M, et al. Thrombolysis in hemodynamically stable patients with acute pulmonary embolism: a meta-analysis［J］. Thromb Res, 2014, 134(6):1265-1271.  ［21］Chen H, Ren C, Chen H. Thrombolysis versus anticoagulation for the initial treatment of moderate pulmonary embolism: a meta-analysis of randomized controlled trials［J］. Respir Care， 2014， 59(12):1880-1887.  ［22］Barrett L, Horner D. BET 1: A glass half full? Thrombolysis for the treatment of submassive pulmonary embolism［J］. Emerg Med J, 2017, 34(5):331-334.  ［23］Brandt K, McGinn K, Quedado J. Low-Dose Systemic Alteplase (tPA) for the Treatment of Pulmonary Embolism. Ann Pharmacother, 2015, 49(7):818-824.  ［24］Wang C, Zhai Z, Yang Y, et al. Efficacy and safety of low dose recombinant tissue-type plasminogen activator for the treatment of acute pulmonary thromboembolism: a randomized, multicenter, controlled trial［J］. Chest, 2010, 137(2):254-262.  ［25］中华医学会外科学分会血管外科学组. 深静脉血栓形成的诊断和治疗指南(第三版)［J］. 中华普通外科杂志, 2017, 32(9):807-812. ［26］伍群, 肖扬, 伍旭辉. 人工髋、膝关节置换术后深静脉血栓诊治的研究进展［J］. 中华骨科杂志, 2015, 35(11):1117-1120. ［27］《血管与腔内血管外科杂志》编辑部, 下肢静脉疾病外科治疗专家协作组. AngioJet机械血栓清除术治疗急性下肢深静脉血栓形成的专家共识(2016版)［J］. 血管与腔内血管外科杂志, 2017, 3(1):555-558.  ［28］Min SK, Kim YH, Joh JH, et al. Diagnosis and Treatment of Lower Extremity Deep Vein Thrombosis: Korean Practice Guidelines［J］. Vasc Specialist Int, 2016, 32(3):77-104. ［29］Robert-Ebadi H, Righini M. Management of distal deep vein thrombosis［J］. Thromb Res, 2017, 149:48-55. ［30］Garry J, Duke A, Labropoulos N. Systematic review of the complications following isolated calf deep vein thrombosis［J］. Br J Surg, 2016, 103(7):789-796.  ［31］Righini M, Galanaud JP, Guenneguez H, et al. Anticoagulant therapy for symptomatic calf deep vein thrombosis (CACTUS): a randomised, double-blind, placebo-controlled trial［J］. Lancet Haematol, 2016, 3(12):e556-e562.  ［32］Mazzolai L, Aboyans V, Ageno W, et al. Diagnosis and management of acute deep vein thrombosis: a joint consensus document from the European Society of Cardiology working groups of aorta and peripheral vascular diseases and pulmonary circulation and right ventricular function［J］. Eur Heart J, 2018, 39(47):4208-4218. ［33］静脉血栓栓塞症抗凝治疗微循环血栓防治共识专家组. 静脉血栓栓塞症抗凝治疗微循环血栓防治专家共识［J］. 中华老年多器官疾病杂志, 2017, 16(4):241-244.  ［34］《中国血栓性疾病防治指南》专家委员会. 中国血栓性疾病防治指南［J］. 中华医学杂志, 2018, 98(36):2861-2888. ［35］中华医学会外科学分会血管外科学组. 利伐沙班临床应用中国专家建议--深静脉血栓形成治疗分册［J］. 中国血管外科杂志（电子版）, 2013, 5(4):209-213. ［36］Carrier M, Blais N, Crowther M, et al. Treatment algorithm in cancer-associated thrombosis: Canadian expert consensus［J］. Curr Oncol, 2018, 25(5):329-337. ［37］Streiff MB, Holmstrom B, Ashrani A, et al. Cancer-Associated Venous Thromboembolic Disease, Version 1.2015［J］. J Natl Compr Canc Netw, 2015, 13(9):1079-1095.  ［38］Di Nisio M, Lee AY, Carrier M, et al. Diagnosis and treatment of incidental venous thromboembolism in cancer patients: guidance from the SSC of the ISTH［J］. J Thromb Haemost, 2015, 13(5):880-883.  ［39］Meissner MH, Gloviczki P, Comerota AJ, et al. Early thrombus removal strategies for acute deep venous thrombosis: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum［J］. J Vasc Surg, 2012, 55(5):1449-1462. ［40］中国医师协会介入医师分会, 中华医学会放射学分会介入专业委员会, 中国静脉介入联盟. 下肢深静脉血栓形成介入治疗规范的专家共识(第2版)［J］. 介入放射学杂志, 2019, 28(1):1-10.  ［41］Tsochatzis EA, Senzolo M, Germani G, et al. Systematic review: portal vein thrombosis in cirrhosis［J］. Aliment Pharmacol Ther, 2010, 31(3):366-374.  ［42］Amitrano L, Guardascione MA, Menchise A, et al. Safety and efficacy of anticoagulation therapy with low molecular weight heparin for portal vein thrombosis in patients with liver cirrhosis［J］. J Clin Gastroenterol, 2010, 44(6):448-451.  ［43］Senzolo M, Rossetto V, Burra P,et al. Prospective evaluation of anticoagulation and transjugular intrahepatic portosystemic shunt for the management of portal vein thrombosis in cirrhosis［J］. Liver Int, 2012, 32(6):919-927. ［44］Huang JS, Luo X, Yu JX, et al. ［Indigenous and imported low molecular weight heparin in the treatment of chronic hepatitis B and cirrhosis with hepatitis B virus: a prospective randomized controlled clinical study［J］. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, 2007,19(7):408-411.  ［45］Qi X, Han G, Fan D. Management of portal vein thrombosis in liver cirrhosis［J］. Nat Rev Gastroenterol Hepatol, 2014, 11(7):435-446.  ［46］Delgado MG, Seijo S, Yepes I, et al. Efficacy and safety of anticoagulation on patients with cirrhosis and portal vein thrombosis［J］. Clin Gastroenterol Hepatol, 2012, 10(7):776-783.  ［47］Werner KT, Sando S, Carey EJ, et al. Portal vein thrombosis in patients with end stage liver disease awaiting liver transplantation: outcome of anticoagulation［J］. Dig Dis Sci, 2013, 58(6):1776-1780. ［48］Qi X, De Stefano V, Li H, et al. Anticoagulation for the treatment of portal vein thrombosis in liver cirrhosis: a systematic review and meta-analysis of observational studies［J］. Eur J Intern Med, 2015, 26(1):23-29.  ［49］Amitrano L, Guardascione MA. Management of portal vein thrombosis in cirrhotic patients［J］. Mediterr J Hematol Infect Dis， 2009， 1(3):e2009014. ［50］Maruyama H, Okugawa H, Takahashi M, et al. De novo portal vein thrombosis in virus-related cirrhosis: predictive factors and long-term outcomes［J］. Am J Gastroenterol, 2013, 108(4):568-574. ［51］Villa E, Camma C, Marietta M, et al. Enoxaparin prevents portal vein thrombosis and liver decompensation in patients with advanced cirrhosis［J］. Gastroenterology, 2012,143(5):1253-1260. ［52］Plessier A, Darwish-Murad S, Hernandez-Guerra M, et al. Acute portal vein thrombosis unrelated to cirrhosis: a prospective multicenter follow-up study［J］. Hepatology, 2010, 51(1):210-218.  ［53］Turnes J, Garcia-Pagan JC, Gonzalez M, et al. Portal hypertension-related complications after acute portal vein thrombosis: impact of early anticoagulation［J］. Clin Gastroenterol Hepatol, 2008, 6(12):1412-1417.  ［54］EASL Clinical Practical Guidelines: Vascular diseases of the liver［J］. Journal of Hepatology. ［55］Cui SB, Shu RH, Yan SP, et al. Efficacy and safety of anticoagulation therapy with different doses of enoxaparin for portal vein thrombosis in cirrhotic patients with hepatitis B［J］. Eur J Gastroenterol Hepatol, 2015, 27(8):914-919.  ［56］Lenz K, Dieplinger B, Buder R, et al. Successful treatment of partial portal vein thrombosis (PVT) with low dose rivaroxaban［J］. Z Gastroenterol, 2014, 52(10):1175-1177.  ［57］Martinez M, Tandra A, Vuppalanchi R. Treatment of acute portal vein thrombosis by nontraditional anticoagulation［J］. Hepatology, 2014, 60(1):425-426.  ［58］Reiberger T, Puspok A, Schoder M, et al. Austrian consensus guidelines on the management and treatment of portal hypertension (Billroth III)［J］. Wien Klin Wochenschr, 2017, 129(Suppl 3):135-158. ［59］Condat B, Pessione F, Hillaire S, et al. Current outcome of portal vein thrombosis in adults: risk and benefit of anticoagulant therapy［J］. Gastroenterology, 2001, 120(2):490-497.  ［60］Francoz C, Belghiti J, Vilgrain V, et al. Splanchnic vein thrombosis in candidates for liver transplantation: usefulness of screening and anticoagulation［J］. Gut, 2005, 54(5):691-697.  ［61］Randi ML, Tezza F, Scapin M, et al. Heparin-induced thrombocytopenia in patients with Philadelphia-negative myeloproliferative disorders and unusual splanchnic or cerebral vein thrombosis［J］. Acta Haematol, 2010, 123(3):140-145.  ［62］Ferro C, Rossi UG, Bovio G, et al. Transjugular intrahepatic portosystemic shunt, mechanical aspiration thrombectomy, and direct thrombolysis in the treatment of acute portal and superior mesenteric vein thrombosis［J］. Cardiovasc Intervent Radiol, 2007, 30(5):1070-1074.  ［63］Hollingshead M, Burke CT, Mauro MA, et al. Transcatheter thrombolytic therapy for acute mesenteric and portal vein thrombosis［J］. J Vasc Interv Radiol, 2005, 16(5):651-661.  ［64］Hmoud B, Singal AK, Kamath PS. Mesenteric venous thrombosis［J］. J Clin Exp Hepatol, 2014, 4(3):257-263.［65］Karawi MA, Quaiz M, Clark D, et al. Mesenteric vein thrombosis, non-invasive diagnosis and follow-up (US + MRI), and non-invasive therapy by streptokinase and anticoagulants［J］. Hepatogastroenterology, 1990, 37(5):507-509.  ［66］Semiz-Oysu A, Keussen I, Cwikiel W. Interventional radiological management of prehepatic obstruction of ［corrected］ the splanchnic venous system［J］. Cardiovasc Intervent Radiol, 2007, 30(4):688-695.  ［67］Sehgal M, Haskal ZJ. Use of transjugular intrahepatic portosystemic shunts during lytic therapy of extensive portal splenic and mesenteric venous thrombosis: long-term follow-up［J］. J Vasc Interv Radiol, 2000, 11(1):61-65.  ［68］Malkowski P, Pawlak J, Michalowicz B, et al. Thrombolytic treatment of portal thrombosis［J］. Hepatogastroenterology, 2003, 50(54):2098-2100.  ［69］Cao G, Ko GY, Sung KB, et al. Treatment of postoperative main portal vein and superior mesenteric vein thrombosis with balloon angioplasty and/or stent placement［J］. Acta Radiol, 2013, 54(5):526-532.  ［70］Bertrand C, Dominique V. Nonmalignant portal vein thrombosis in adults［J］. Nat Clin Pract Gastroenterol Hepatol, 2006, 3(9):505-515. ［71］Thygesen K, Alpert JS, Jaffe AS, et al. Fourth Universal Definition of Myocardial Infarction (2018)［J］. Glob Heart, 2018, 13(4):305-338.  ［72］Levine GN, Bates ER, Bittl JA, et al. 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines［J］. J Am Coll Cardiol, 2016, 68(10):1082-1115. ［73］Yusuf S, Mehta SR, Chrolavicius S, et al. Effects of fondaparinux on mortality and reinfarction in patients with acute ST-segment elevation myocardial infarction - The OASIS-6 randomized trial［J］. J Am Med Assoc, 2006, 295(13):1519-1530. ［74］Gao XF, Chen Y, Fan ZG, et al. Antithrombotic Regimens for Patients Taking Oral Anticoagulation After Coronary Intervention: A Meta-analysis of 16 Clinical Trials and 9,185 Patients［J］. Clin Cardiol, 2015, 38(8):499-509.  ［75］Cannon CP, Gropper S, Bhatt DL, et al. Design and Rationale of the RE-DUAL PCI Trial: A Prospective, Randomized, Phase 3b Study Comparing the Safety and Efficacy of Dual Antithrombotic Therapy With Dabigatran Etexilate Versus Warfarin Triple Therapy in Patients With Nonvalvular Atrial Fibrillation Who Have Undergone Percutaneous Coronary Intervention With Stenting［J］. Clin Cardiol, 2016, 39(10):555-564.  ［76］中国医师协会心血管内科医师分会血栓防治专业委员会, 中华医学会心血管病学分会介入心脏病学组, 中华心血管病杂志编辑委员会. 急性冠状动脉综合征特殊人群抗血小板治疗中国专家建议［J］. 中华心血管病杂志, 2018, 46(4):255-266.  ［77］中国医师协会心血管内科医师分会. 急性冠状动脉综合征抗栓治疗合并出血防治多学科专家共识［J］. 中华内科杂志,2016, 55(10):813-824. ［78］Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics--2011 update: a report from the American Heart Association［J］. Circulation, 2011, 123(4):e18-e209. ［79］Wang W, Jiang B, Sun H, et al. Prevalence, Incidence, and Mortality of Stroke in China: Results from a Nationwide Population-Based Survey of 480 687 Adults［J］. Circulation, 2017, 135(8):759-771.  ［80］Lyden P, Brott T, Tilley B, et al. Improved Reliability of the Nih Stroke Scale Using Video Training［J］. Stroke, 1994, 25(11):2220-2226.  ［81］Josephson SA, Hills NK, Johnston SC. NIH Stroke Scale reliability in ratings from a large sample of clinicians［J］. Cerebrovasc Dis, 2006, 22(5-6):389-395.  ［82］Lyden P, Raman R, Liu L, et al. National Institutes of Health Stroke Scale Certification Is Reliable Across Mutiple Venues［J］. Stroke, 2009, 40(7):2507-2511.  ［83］中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018［J］. 中华神经科杂志, 2018, 51(9):666-682.  ［84］陈清棠, 贺茂林, 徐忠宝, 等. 急性脑梗死(6h以内)静脉溶栓治疗［J］. 中风与神经疾病杂志, 2001, 18(5):259-261.  ［85］Campbell BCV, Mitchell PJ, Churilov L,et al. Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke［J］. N Engl J Med, 2018, 378(17):1573-1582.  ［86］Sandercock P, Collins R, Counsell C, et al. The International Stroke Trial (IST): A randomised trial of aspirin, subcutaneous heparin, both, or neither among 19 435 patients with acute ischaemic stroke［J］. Lancet, 1997, 349(9065):1569-1581.  ［87］Listed N. CAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. CAST (Chinese Acute Stroke Trial) Collaborative Group［J］. Lancet, 1997, 349(9066):1641. ［88］Wang YJ, Wang YL, Zhao XQ, et al. Clopidogrel with Aspirin in Acute Minor Stroke or Transient Ischemic Attack［J］. N Engl J Med, 2013, 369(1):11-19.  ［89］Sandercock PAG, Counsell C, Kamal AK. Anticoagulants for acute ischaemic stroke［J］. Cochrane Database of Systematic Reviews, 2008, (4):CD000024. ［90］Whiteley WN, Adams HP, Bath PMW, et al. Targeted use of heparin, heparinoids, or low-molecular-weight heparin to improve outcome after acute ischaemic stroke: an individual patient data meta-analysis of randomised controlled trials［J］. Lancet Neurology, 2013, 12(6):539-545. ［91］Xingyang Y, Jing L, Chun W, et al. Low-molecular-weight heparin is more effective than aspirin in preventing early neurologic deterioration and improving six-month outcome［J］. J Stroke Cerebrovasc Dis, 2014, 23(6):1537-1544. ［92］Adam DJ, Beard JD, Cleveland T, et al. Bypass versus angioplasty insevere ischaemia of the leg (BASIL): multicentre, randomised controlled trial［J］. Lancet, 2005, 366(9501):1925-1934.  ［93］Norgren L, Hiatt WR, Dormandy JA, et al. Inter-society consensus for the management of peripheral arterial disease［J］. Int Angiol, 2007, 26(2):81-157.  ［94］Sobel M, Verhaeghe R. Antithrombotic Therapy for Peripheral Artery Occlusive Disease : American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)［J］. Chest, 2008, 133(6):815S-43S. ［95］Collaborati HPS. Randomized trial of the effects of cholesterol-lowering with simvastatin on peripheral vascular and other major vascular outcomes in 20,536 people with peripheral arterial disease and other high-risk conditions［J］. Journal of Vascular Surgery, 2007, 45(4):645-653.  ［96］Diehm N, Schillinger M, Minar E, et al. TASC II section E3 on the treatment of acute limb ischemia: Commentary from European interventionists［J］. J Endovasc Ther, 2008, 15(1):126-128. ［97］Pilger E, Pabst E, Kostner G, et al. Prevention of serious vascular events by aspirin amongst patients with peripheral arterial disease: randomized, double-blind trial［J］. J Intern Med, 2007, 261(3):276-284.  ［98］Dormandy JA. Prostanoid drug therapy for peripheral arterial occlusive disease--the European experience［J］. Vasc Med, 1996, 1(2):155-158.  ［99］Creutzig A, Lehmacher W, Elze M. Meta-analysis of randomised controlled prostaglandin E1 studies in peripheral arterial occlusive disease stages III and IV［J］. Vasa Zeitschrift Fur Gefasskrankheiten, 2004, 33(3):137. ［100］Ouriel K, Veith FJ, Sasahara AA. A comparison of recombinant urokinase with vascular surgery as initial treatment for acute arterial occlusion of the legs［J］. N Engl J Med, 1998, 338(16):1105-1011. ［101］Bradbury AW, Particip BTI. Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial in perspective［J］. J Vasc Surg, 2010, 51(5 Suppl):1s-4s.  ［102］Johnson WC, Williford WO, Study DVAC. Benefits, morbidity, and mortality associated with long-term administration of oral anticoagulant therapy to patients with peripheral arterial bypass procedures: A prospective randomized study［J］. Journal of Vascular Surgery, 2002, 35(3):413-421.  ［103］Goette A, Kalman JM, Aguinaga L, et al. EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: Definition, characterization, and clinical implication［J］. Heart Rhythm, 2017, 14(1):e3-e40.  ［104］Schnabel RB, Yin X, Gona P, et al. 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study［J］. Lancet, 2015, 386(9989):154-162.  ［105］Fuster V, Ryden LE, Cannom DS, et al. 2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines 2006 WRITING COMMITTEE MEMBERS Developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society［J］. Journal of the American College of Cardiology, 2011, 57(11):E101-E198.  ［106］Mittal MK, Rabinstein AA. Anticoagulation-related intracranial hemorrhages［J］. Curr Atheroscler Rep, 2012, 14(4):351-359.  ［107］Lip GYH, Banerjee A, Boriani G, et al. Antithrombotic Therapy for Atrial Fibrillation: CHEST Guideline and Expert Panel Report［J］. Chest, 2018, 154(5):1121-1201. ［108］Eikelboom JW, Wallentin L, Connolly SJ, et al. Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: an analysis of the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial［J］. Circulation, 2011, 123(21):2363-2372.  ［109］Ruff CT, Giugliano RP, Braunwald E, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials［J］. Lancet, 2014, 383(9921):955-962. ［110］Airaksinen KE, Gronberg T, Nuotio I, et al. Thromboembolic complications after cardioversion of acute atrial fibrillation: the FinCV (Finnish CardioVersion) study［J］. J Am Coll Cardiol, 2013, 62(13):1187-1192.  ［111］Nuotio I, Hartikainen JE, Gronberg T, et al. Time to cardioversion for acute atrial fibrillation and thromboembolic complications［J］. JAMA, 2014, 312(6):647-649. ［112］Angiolillo DJ, Goodman SG, Bhatt DL, et al. Antithrombotic Therapy in Patients With Atrial Fibrillation Treated With Oral Anticoagulation Undergoing Percutaneous Coronary Intervention［J］. Circulation, 2018, 138(5):527-536.  ［113］Hart RG, Pearce LA, Aguilar MI. Meta-analysis: Antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation［J］. Ann Intern Med, 2007, 146(12):857-867.  ［114］Lip GYH, Al-Khatib SM, Cosio FG, et al. Contemporary Management of Atrial Fibrillation: What Can Clinical Registries Tell Us About Stroke Prevention and Current Therapeutic Approaches［J］. J Am Heart Assoc, 2014, 3(4)pii: e001179. ［115］Gorst-Rasmussen A, Skjoth F, Larsen TB, et al. Dabigatran adherence in atrial fibrillation patients during the first year after diagnosis: a nationwide cohort study［J］. Journal of Thrombosis and Haemostasis, 2015, 13(4):495-504.  ［116］Lip GYH, Skjoth F, Rasmussen LH, et al. Oral Anticoagulation, Aspirin, or No Therapy in Patients With Nonvalvular AF With 0 or 1 Stroke Risk Factor Based on the CHA(2)DS(2)-VASc Score［J］. Journal of the American College of Cardiology, 2015, 65(14):1385-1394.  ［117］Fauchier L, Lecoq C, Clementy N, et al. Oral Anticoagulation and the Risk of Stroke or Death in Patients With Atrial Fibrillation and One Additional Stroke Risk Factor: The Loire Valley Atrial Fibrillation Project［J］. Chest, 2016, 149(4):960-968.  ［118］Joundi RA, Cipriano LE, Sposato LA, et al. Ischemic Stroke Risk inPatients With Atrial Fibrillation and CHA2DS2-VASc Score of 1: Systematic Review and Meta-Analysis［J］. Stroke, 2016, 47(5):1364-1367.  ［119］Pisters R, Lane DA, Nieuwlaat R, et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey［J］. Chest, 2010, 138(5):1093-1100. ［120］Lip GY, Frison L, Halperin JL, et al. Comparative validation of a novel risk score for predicting bleeding risk in anticoagulated patients with atrial fibrillation: the HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) score［J］. J Am Coll Cardiol, 2011, 57(2):173-180.  ［121］Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS［J］. Kardiol Pol, 2016, 74(12):1359-1469.  ［122］Staerk L, Sherer JA, Ko D, et al. Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes［J］. Circ Res, 2017, 120(9):1501-1517.  ［123］Steffel J, Verhamme P, Potpara TS, et al. The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: executive summary［J］. Europace, 2018, 20(8):1231-1242. ［124］Steiner T, Bohm M, Dichgans M, et al. Recommendations for the emergency management of complications associated with the new direct oral anticoagulants (DOACs), apixaban, dabigatran and rivaroxaban［J］. Clin Res Cardiol, 2013, 102(6):399-412.  ［125］Desai J, Kolb JM, Weitz JI, et al. Gastrointestinal bleeding with the new oral anticoagulants - defining the issues and the management strategies［J］. Thromb Haemostasis, 2013, 110(2):205-212.  ［126］Bonaca MP, Bhatt DL, Cohen M, et al. Long-term use of ticagrelor in patients with prior myocardial infarction［J］. 岭南心血管病杂志：英文版, 2015, 372(1):60-61. ［127］Kereiakes DJ, Yeh RW, Massaro JM, et al. DAPT Score Utility for Risk Prediction in Patients With or Without Previous Myocardial Infarction［J］. Journal of the American College of Cardiology, 2016, 67(21):2492-502. ［128］Han Y, Xu B, Xu K, et al. Six Versus 12 Months of Dual Antiplatelet Therapy After Implantation of Biodegradable Polymer Sirolimus-Eluting Stent: Randomized Substudy of the I-LOVE-IT 2 Trial［J］. Circ Cardiovasc Interv, 2016, 9(2):e003145.  ［129］Vaduganathan M, Cannon CP, Cryer BL, et al. Safety of Proton-Pump Inhibitors in High-Risk Cardiovascular Subsets of the COGENT Trial［J］. Am J Med, 2016, 129(9):1002-1005. ［130］Katz PO, Gerson LB, Vela MF. Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease (vol 108, pg 308, 2013)［J］. Am J Gastroenterol, 2013, 108(10):1672.  ［131］Mehran R, Rao SV, Bhatt DL, Gibson CM, et al. Standardized bleeding definitions for cardiovascular clinical trials: a consensus report from the Bleeding Academic Research Consortium［J］. Circulation, 2011, 123(23):2736-2747.  ［132］Navin Victor, Jayadev Umakanthan, Apurva Gandhi, et al. 419: role of platelet transfusion in gastrointestinal bleeding in patients on anti-platelet therapy［J］. Crit Care Med, 2014, 42(12 Suppl). ［133］Odutayo A, Desborough MJ, Trivella M, et al. Restrictive versus liberal blood transfusion for gastrointestinal bleeding: a systematic review and meta-analysis of randomised controlled trials［J］. Lancet Gastroenterology & Hepatology, 2017, 2(5):354. ［134］Fabricius R, Svenningsen P, Hillings J, et al. Effect of Transfusion Strategy in Acute Non-variceal Upper Gastrointestinal Bleeding: A Nationwide Study of 5861 Hospital Admissions in Denmark［J］. World Journal of Surgery, 2016, 40(5):1129. ［135］Restellini S, Kherad O, Jairath V, et al. Red blood cell transfusion is associated with increased rebleeding in patients with nonvariceal upper gastrointestinal bleeding［J］. Aliment PharmacolTher, 2013, 37(3):316-322. ［136］Joseph JYS, James YWL, Jessica YLC, et al. Continuation of low-dose aspirin therapy in peptic ulcer bleeding: a randomized trial［J］. Chinese General Practice, 2010, 152(1):1-9. ［137］Derogar M, Sandblom G, Lundell L, et al. Discontinuation of low-dose aspirin therapy after peptic ulcer bleeding increases risk of death and acute cardiovascular events［J］. Clinical Gastroenterology & Hepatology the Official Clinical Practice Journal of the American Gastroenterological Association, 2013, 11(1):38-42. ［138］Chun-Peng L, Wen-Chi C, Kwok-Hung L, et al. Esomeprazole alone compared with esomeprazole plus aspirin for the treatment of aspirin-related peptic ulcers［J］. Am J Gastroenterol, 2012, 107(7):1022-1029. ［139］Abraham NS, Christine H, Peter R, et al. Risk of lower and upper gastrointestinal bleeding, transfusions, and hospitalizations with complex antithrombotic therapy in elderly patients［J］. Circulation, 2013, 128(17):1869-1877. ［140］Eisenberg MJ, Richard PR, Danielle L, et al. Safety of short-term discontinuation of antiplatelet therapy in patients with drug-eluting stents［J］. Circulation, 2009, 119(12):1634-1642. ［141］Gage BF, Waterman AD, Shannon W, et al. Validation of Clinical Classification Schemes for Predicting Stroke: Results From the National Registry of Atrial Fibrillation［J］. JAMA, 2001, 285(22):2864-2870. ［142］Qureshi WT, Nasir U. Restarting oral anticoagulation among patients with atrial fibrillation with gastrointestinal bleeding was associated with lower risk of all-cause mortality and thromboembolism［J］. Evid Based Med, 2016, 21(4):152. ［143］Qureshi W, Mittal C, Patsias I, et al. Restarting anticoagulation and outcomes after major gastrointestinal bleeding in atrial fibrillation［J］. Am J Cardiol, 2014, 113(4):662-668. ［144］Staerk L, Lip GYH, Olesen JB, et al. Stroke and recurrent haemorrhage associated with antithrombotic treatment after gastrointestinal bleeding in patients with atrial fibrillation: nationwide cohort study［J］. BMJ, 2015, 351(2):h5876. ［145］Scott MJ, Veitch A, Thachil J. Reintroduction of anti-thrombotic therapy after a gastrointestinal haemorrhage: if and when［J］.Br J Haematol, 2017, 177(2):185-197. ［146］Gerhardt A, Scharf RE, Zotz RB. Hereditary risk factors of thrombophilia and the individual probability of first venous thromboembolism (VTE) in pregnancy and puerperium［J］. J Thromb Haemost, 2015, 13:221.  ［147］Obstetritians RCO. Reducing the risk of thrombosis and embolism during pregnancy and the puerperium［J］. 2009. ［148］Linnemann B, Bauersachs R, Rott H, et al. Diagnosis of pregnancy-associated venous thromboembolism - position paper of the Working Group in Women's Health of the Society of Thrombosis and Haemostasis (GTH)［J］. Vasa Zeitschrift Fur Gefasskrankheiten, 2016, 45(2):87. ［149］Jackson SP. Arterial thrombosis--insidious, unpredictable and deadly［J］. Nat Med, 2011, 17(11):1423-1436.  ［150］Pokorney SD, Simon DN, Thomas L, et al. Stability of International Normalized Ratios in Patients Taking Long-term Warfarin Therapy［J］. JAMA, 2016, 316(6):661-663. ［151］Smythe MA, Priziola J, Dobesh PP, et al. Guidance for the practical management of the heparin anticoagulants in the treatment of venous thromboembolism［J］. J Thromb Thrombolysis, 2016, 41(1):165-186. ［152］Mismetti P, Laporte S. New oral antithrombotics: a need for laboratory monitoring［J］.J Thromb Haemost, 2010, 8(4):627-630. ［153］Corina E, Thorsten S. Acute stroke in patients on new direct oral anticoagulants: how to manage, how to treat［J］. Expert Opin Pharmacother, 2014, 15(14):1991-2001. ［154］Favaloro EJ, Lippi G. The new oral anticoagulants and the future of haemostasis laboratory testing［J］. Biochem Med (Zagreb), 2012, 22(3):329-341.  ［155］Tantry US, Bonello L, Aradi D, et al. Consensus and Update on the Definition of On-Treatment Platelet Reactivity to Adenosine Diphosphate Associated With Ischemia and Bleeding［J］.J Am Coll Cardiol, 2013, 62(24):2261-2273. ［156］Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS［J］. Eur Heart J, 2016, 74(12):1359.