Research progress of low-dose rivaroxaban combined with aspirin in the treatment of atherosclerotic disease
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摘要: 近年来，动脉粥样硬化疾病成为威胁人类健康的主要疾病，冠心病(CHD)和外周血管疾病(PAD)患者的二级预防至关重要，主要以抗血小板治疗为重中之重，然而，缺血和出血风险如何平衡仍然是一个挑战。近年来重要的临床研究显示，长期使用小剂量利伐沙班和阿司匹林联用在二级预防治疗中可显著降低CHD和PAD患者的不良心血管事件，具有良好的安全性。本文就利伐沙班在心血管疾病患者中的病理生理影响，以及治疗中的有效性及安全性的研究进展进行讨论，为临床医生的个体化用药方案提供参考。Abstract: In recent years, the atherosclerotic disease has become a major threat to human health. The secondary prevention of coronary heart disease(CHD) and peripheral vascular disease(PAD) patients is crucial, and anti-platelet therapy is the top priority. However, how ischemic and bleeding risks are balanced remains a challenge. Important clinical studies in recent years have shown that long-term use of low-dose rivaroxaban in combination with aspirin in secondary prevention therapy can significantly reduce adverse cardiovascular events in patients with CHD and PAD, with good safety. This article discusses the pathophysiological effects of rivaroxaban in patients with cardiovascular disease, as well as the research progress on the efficacy and safety of the treatment, providing a reference for clinicians' individualized drug regimen.
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表 1 利伐沙班适应证、给药剂量和治疗方案
Table 1. Rivaroxaban indications, dosage and treatment regimen
利伐沙班剂量 适应证 名称 利伐沙班15 mg bid VTE治疗急性期 最高全剂量抗凝 利伐沙班20 mg qd 心房颤动VTE二级预防长期阶段的卒中预防 全剂量抗凝 利伐沙班10 mg qd VTE预防二级VTE预防 预防剂量 利伐沙班2.5 mg bid+DAPT ACS后的二级预防 血管剂量 利伐沙班2.5 mg bid+阿司匹林100 mg qd 降低CAD和(或)PAD患者心血管死亡事件二级预防的风险 双通路抑制 
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