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中华重症医学电子杂志 ›› 2025, Vol. 11 ›› Issue (04) : 402 -406. doi: 10.3877/cma.j.issn.2096-1537.2025.04.011

综述

脓毒症合并新发心房颤动抗凝治疗策略的研究进展
周涛, 程梓荷, 郑宏芳, 刘佳奇, 许雪琴, 王胜昱()   
  1. 710003 西安,西安医学院第一附属医院呼吸与危重症医学科
  • 收稿日期:2024-07-16 出版日期:2025-11-28
  • 通信作者: 王胜昱
  • 基金资助:
    西安医学院呼吸与危重症疾病的基础与转化研究创新团队(2021TD13); 急性肺损伤防治基础与转化陕西省高等学校重点实验室(陕教函[2024] 21号); 急性肺损伤防治基础与转化陕西高校青年创新团队(陕教函[2023] 997号)

Current anticoagulation treatment strategies for sepsis with new-onset atrial fibrillation

Tao Zhou, Zihe Cheng, Hongfang Zheng, Jiaqi Liu, Xueqin Xu, Shengyu Wang()   

  1. Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Medical University, Xi'an 710003, China
  • Received:2024-07-16 Published:2025-11-28
  • Corresponding author: Shengyu Wang
引用本文:

周涛, 程梓荷, 郑宏芳, 刘佳奇, 许雪琴, 王胜昱. 脓毒症合并新发心房颤动抗凝治疗策略的研究进展[J/OL]. 中华重症医学电子杂志, 2025, 11(04): 402-406.

Tao Zhou, Zihe Cheng, Hongfang Zheng, Jiaqi Liu, Xueqin Xu, Shengyu Wang. Current anticoagulation treatment strategies for sepsis with new-onset atrial fibrillation[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2025, 11(04): 402-406.

脓毒症可导致心房颤动的发生,合并心房颤动后,脓毒症患者住院时间延长,住院死亡风险增加。与无心房颤动的脓毒症患者相比,脓毒症所致的心房颤动可以使患者的住院卒中风险增加近3倍。在临床上,对于是否应对脓毒症合并心房颤动患者实施抗凝治疗存在分歧:一方面,有观点认为抗凝治疗能够降低缺血性卒中的发生率;另一方面,亦有观点指出,脓毒症合并心房颤动时给予抗凝治疗会增加出血风险。鉴于此,本文综合国内外现有文献资料,探讨脓毒症期间合并心房颤动,特别是新发心房颤动,是否应启动抗凝治疗的问题,以期增进临床医师对脓毒症合并心房颤动后抗凝模式的深入理解,为更好地平衡抗凝治疗的潜在益处及其可能带来的出血风险提供参考。

Sepsis can trigger the onset of atrial fibrillation (AF). When AF occurs in septic patients, hospital length of stay is often prolonged, and the risk of in-hospital mortality increases. Compared to septic patients without AF, those with sepsis-induced AF face nearly a threefold increase in the risk of in-hospital stroke. Clinically, there is an ongoing debate over whether anticoagulant therapy should be administered to septic patients with concurrent AF. Some advocate for anticoagulation to reduce the incidence of ischemic stroke, while other caution that it may increase the risk of bleeding. In light of these differing perspectives, this article reviews both domestic and international literature to explore whether anticoagulant therapy should be initiated in septic patients with AF, particularly in cases of new-onset AF. The goal is to enhance clinicians' understanding of anticoagulation strategies in this context and to provide guidance on better balancing the potential benefits of anticoagulation with the associated risks of bleeding.

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