参考文献
[1] 中华心血管病杂志(网络版)编辑委员会. 口服抗栓药物相关消化道损伤防治专家共识 [J/OL]. 中华心血管病杂志(网络版),2021,4:e1000081(2021‑08‑09)[2025-12-10]. http://www.cvjc.org.cn/index.php/Column/columncon/article_id/249. DOI:10.3760/cma.j.cn116031.2021.1000081.
[2] 《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. DOI: 10.3760/cma.j.issn.0376‑2491.2018.36.002.
[3] Desai J, Kolb JM, Weitz JI, et al. Gastrointestinal bleeding with the new oral anticoagulants‑‑defining the issues and the management strategies[J]. Thromb Haemost, 2013, 110(2):205‑212. DOI: 10.1160/TH13‑02‑0150.
[4] Lanas A, García‑Rodríguez LA, Arroyo MT, et al. Risk of upper gastrointestinal ulcer bleeding associated with selective cyclo‑oxygenase‑2 inhibitors, traditional non‑aspirin non‑steroidal anti‑inflammatory drugs, aspirin and combinations[J]. Gut, 2006, 55(12):1731‑1738. DOI: 10.1136/gut.2005.080754.
[5] Vaduganathan M, Bhatt DL. Gastrointestinal bleeding with oral anticoagulation:understanding the scope of the problem[J]. Clin Gastroenterol Hepatol, 2017, 15(5):691‑693. DOI: 10.1016/j.cgh.2016.12.033.
[6] 中华医学会心血管病学分会, 中华医学会心电生理和起搏分会, 中国医师协会心律学专业委员会. 非瓣膜病心房颤动患者新型口服抗凝药的应用中国专家共识[J]. 中华心律失常学杂志, 2014, 18(5):321‑329. DOI: 10.3760/cma.j.issn.1007‑6638.2014.05.001.
[7] Maruyama K, Yamamoto T, Aoyagi H, et al. Difference between the upper and the lower gastrointestinal bleeding in patients taking nonvitamin K oral anticoagulants[J]. Biomed Res Int, 2018,2018:7123607. DOI: 10.1155/2018/7123607.
[8] Deutsch D, Romegoux P, Boustière C, et al. Clinical and endoscopic features of severe acute gastrointestinal bleeding in elderly patients treated with direct oral anticoagulants: a multicentre study[J]. Therap Adv Gastroenterol, 2019,12:1756284819851677. DOI: 10.1177/1756284819851677.
[9] Collet JP, Thiele H, Barbato E, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST‑segment elevation[J]. Eur Heart J, 2021, 42(14):1289‑1367. DOI: 10.1093/eurheartj/ehaa575.
[10] Miller CS, Dorreen A, Martel M, et al. Risk of gastrointestinal bleeding in patients taking non‑vitamin K antagonist oral anticoagulants: a systematic review and meta‑analysis[J]. Clin Gastroenterol Hepatol, 2017, 15(11):1674‑1683.e3. DOI: 10.1016/j.cgh.2017.04.031.
[11] Abraham NS, Noseworthy PA, Yao X, et al. Gastrointestinal safety of direct oral anticoagulants: a large population‑based study[J]. Gastroenterology, 2017, 152(5):1014‑1022.e1. DOI: 10.1053/j.gastro.2016.12.018.
[12] 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. DOI: 10.1016/j.chest.2015.11.026.
[13] Ageno W, Donadini M. Breadth of complications of long‑term oral anticoagulant care[J]. Hematology Am Soc Hematol Educ Program, 2018, 2018(1):432‑438. DOI: 10.1182/asheducation‑2018.1.432.
[14] Gronich N, Stein N, Muszkat M. Association between use of pharmacokinetic‑interacting drugs and effectiveness and safety of direct acting oral anticoagulants: nested case‑control study[J]. Clin Pharmacol Ther, 2021, 110(6):1526‑1536. DOI: 10.1002/cpt.2369.
[15] Kyaw MH, Chan F. Managing antithrombotic agents in the setting of acute gastrointestinal bleeding[J]. Gastrointest Endosc Clin N Am, 2018, 28(3):351‑361. DOI: 10.1016/j.giec.2018.02.007.
[16] Steffel J, Collins R, Antz M, et al. 2021 European Heart Rhythm Association practical guide on the use of non‑vitamin K antagonist oral anticoagulants in patients with atrial fibrillation[J]. Europace, 2021, 23(10):1612‑1676. DOI: 10.1093/europace/euab065.
[17] CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee[J]. Lancet, 1996, 348(9038):1329‑1339. DOI: 10.1016/s0140‑6736(96)09457‑3.
[18] Tsai TJ, Lai KH, Hsu PI, et al. Upper gastrointestinal lesions in patients receiving clopidogrel anti‑platelet therapy[J]. J Formos Med Assoc, 2012, 111(12):705‑710. DOI: 10.1016/j.jfma.2011.11.028.
[19] Koo BK, Kang J, Park KW, et al. Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention (HOST‑EXAM): an investigator‑initiated, prospective, randomised, open‑label, multicentre trial[J]. Lancet, 2021, 397(10293):2487‑2496. DOI: 10.1016/S0140‑6736(21)01063‑1.
[20] Kang J, Park KW, Lee H, et al. Aspirin versus clopidogrel for long‑term maintenance monotherapy after percutaneous coronary intervention: the HOST‑EXAM Extended Study[J]. Circulation, 2023, 147(2):108‑117. DOI: 10.1161/CIRCULATIONAHA.122.062770.
[21] Choi KH, Park YH, Lee JY, et al. Efficacy and safety of clopidogrel versus aspirin monotherapy in patients at high risk of subsequent cardiovascular event after percutaneous coronary intervention (SMART‑CHOICE 3): a randomised, open‑label, multicentre trial[J]. Lancet, 2025, 405(10486):1252‑1263. DOI: 10.1016/S0140‑6736(25)00449‑0.
[22] Li Y, Li J, Wang B, et al. Extended clopidogrel monotherapy vs DAPT in patients with acute coronary syndromes at high ischemic and bleeding risk: the OPT‑BIRISK Randomized Clinical Trial[J]. JAMA Cardiol, 2024, 9(6):523‑531. DOI: 10.1001/jamacardio.2024.0534.
[23] Wang X, Qi H, Wu Y, et al. The efficacy and safety of lower‑dose aspirin for primary and secondary prevention of cardiovascular disease in the elderly: an interim analysis of a multicenter, prospective, observational study[J]. Front Cardiovasc Med, 2025,12:1615074. DOI: 10.3389/fcvm.2025.1615074.
[24] Wu H, Xu L, Zhao X, et al. Indobufen or aspirin on top of clopidogrel after coronary drug‑eluting stent implantation (OPTION): a randomized, open‑label, end point‑blinded, noninferiority trial[J]. Circulation, 2023, 147(3):212‑222. DOI: 10.1161/CIRCULATIONAHA.122.062762.
[25] Dai C, Liu M, Yang Z, et al. Real‑world performance of indobufen versus aspirin after percutaneous coronary intervention: insights from the ASPIRATION registry[J]. BMC Med, 2024, 22(1):148. DOI: 10.1186/s12916‑024‑03374‑3.
[26] Guo CG, Chen L, Chan EW, et al. Systematic review with meta‑analysis: the risk of gastrointestinal bleeding in patients taking third‑generation P2Y12 inhibitors compared with clopidogrel[J]. Aliment Pharmacol Ther, 2019, 49(1):7‑19. DOI: 10.1111/apt.15059.
[27] 周春华, 赵九龙, 方雪, 等. 华法林相关消化道出血的临床特点及预防治疗策略[J]. 中华内科杂志, 2018, 57(6):469‑472. DOI: 10.3760/cma.j.issn.0578‑1426.2018.06.017.
[28] Benamouzig R, Guenoun M, Deutsch D, et al. Review article: gastrointestinal bleeding risk with direct oral anticoagulants[J]. Cardiovasc Drugs Ther, 2022, 36(5):973‑989. DOI: 10.1007/s10557‑021‑07211‑0.
[29] Guo WQ, Chen XH, Tian XY, et al. Differences in gastrointestinal safety profiles among novel oral anticoagulants: evidence from a network meta‑analysis[J]. Clin Epidemiol, 2019,11:911‑921. DOI: 10.2147/CLEP.S219335.
[30] Aisenberg J, Chatterjee‑Murphy P, Friedman Flack K, et al. Gastrointestinal bleeding with edoxaban versus warfarin: results from the ENGAGE AF‑TIMI 48 Trial (effective anticoagulation with factor Xa next generation in atrial fibrillation‑thrombolysis in myocardial infarction)[J]. Circ Cardiovasc Qual Outcomes, 2018, 11(5):e003998. DOI: 10.1161/CIRCOUTCOMES.117.003998.
[31] Yamashita T, Koretsune Y, Yang Y, et al. Edoxaban vs. warfarin in East Asian patients with atrial fibrillation ‑an ENGAGE AF‑TIMI 48 subanalysis[J]. Circ J, 2016, 80(4):860‑869. DOI: 10.1253/circj.CJ‑15‑1082.
[32] Lee SR, Choi EK, Han KD, et al. Edoxaban in Asian patients with atrial fibrillation: effectiveness and safety[J]. J Am Coll Cardiol, 2018, 72(8):838‑853. DOI: 10.1016/j.jacc.2018.05.066.
[33] Kwon S, Lee SR, Choi EK, et al. Non‑vitamin K antagonist oral anticoagulants in patients with atrial fibrillation and prior gastrointestinal bleeding[J]. Stroke, 2021, 52(2):511‑520. DOI: 10.1161/STROKEAHA.120.030761.
[34] Chey WD, Howden CW, Moss SF, et al. ACG clinical guideline: treatment of helicobacter pylori infection[J]. Am J Gastroenterol, 2024, 119(9):1730‑1753. DOI: 10.14309/ajg.0000000000002968.
[35] Costa F, van Klaveren D, James S, et al. Derivation and validation of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE‑DAPT) score: a pooled analysis of individual‑patient datasets from clinical trials[J]. Lancet, 2017, 389(10073):1025‑1034. DOI: 10.1016/S0140‑6736(17)30397‑5.
[36] Urban P, Mehran R, Colleran R, et al. Defining high bleeding risk in patients undergoing percutaneous coronary intervention: a consensus document from the Academic Research Consortium for High Bleeding Risk[J]. Eur Heart J, 2019, 40(31):2632‑2653. DOI: 10.1093/eurheartj/ehz372.
[37] 质子泵抑制剂预防性应用专家共识写作组. 质子泵抑制剂预防性应用专家共识(2018)[J]. 中国医师杂志, 2018, 20(12):1775‑1781. DOI: 10.3760/cma.j.issn.1008‑1372.2018.12.005.
[38] Tsujita K, Deguchi H, Uda A, et al. Upper gastrointestinal bleeding in Japanese patients with ischemic heart disease receiving vonoprazan or a proton pump inhibitor with multiple antithrombotic agents: a nationwide database study[J]. J Cardiol, 2020, 76(1):51‑57. DOI: 10.1016/j.jjcc.2020.02.012.
[39] Baik M, Jeon J, Yoo J, et al. Effect of potassium‑competitive acid blockers on upper gastrointestinal bleeding in patients on dual antiplatelet therapy after percutaneous coronary intervention: a Nationwide Cohort Study[J]. J Gastroenterol Hepatol, 2025, 40(7):1686‑1694. DOI: 10.1111/jgh.16989.
[40] Valgimigli M, Bueno H, Byrne RA, et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: the Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio‑Thoracic Surgery (EACTS)[J]. Eur Heart J, 2018, 39(3):213‑260. DOI: 10.1093/eurheartj/ehx419.
[41] Eikelboom JW, Connolly SJ, Bosch J, et al. Bleeding and new cancer diagnosis in patients with atherosclerosis[J]. Circulation, 2019, 140(18):1451‑1459. DOI: 10.1161/CIRCULATIONAHA. 119.041949.
[42] 中华医学会心电生理和起搏分会, 中国医师协会心律学专业委员会, 黄从新, 等. 中国心房颤动管理指南(2025)[J]. 中国心脏起搏与心电生理杂志, 2025, 39(4):273‑343. DOI: 10.13333/j.cnki.cjcpe.2025.04.001.
[43] Van Gelder IC, Rienstra M, Bunting KV, et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio‑Thoracic Surgery (EACTS)[J]. Eur Heart J, 2024, 45(36):3314‑3414. DOI: 10.1093/eurheartj/ehae176.
[44] 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. DOI: 10.3760/cma.j.issn.0253‑3758.2018.04.003.
[45] Elshaer A, Abraham NS. Management of anticoagulant and antiplatelet agents in acute gastrointestinal bleeding and prevention of gastrointestinal bleeding[J]. Gastrointest Endosc Clin N Am, 2024, 34(2):205‑216. DOI: 10.1016/j.giec.2023.09.002.
[46] 霍勇,王拥军,谷涌泉,等.常用口服抗血小板药物不耐受及低反应性人群诊疗专家共识 [J/OL]. 中华心血管病杂志(网 络 版),2021,4:e1000076(2021‑05‑21)[2025-12-10]. http://www.cvjc.org.cn/index.php/Column/columncon/article_id/244. DOI:10.3760/cma.j.cn116031.2021.1000076.
[47] Lanas Á, Carrera‑Lasfuentes P, Arguedas Y, et al. Risk of upper and lower gastrointestinal bleeding in patients taking nonsteroidal anti‑inflammatory drugs, antiplatelet agents, or anticoagulants[J]. Clin Gastroenterol Hepatol, 2015, 13(5):906‑912.e2. DOI: 10.1016/j.cgh.2014.11.007.
[48] Wang ZY, Chen M, Zhu LL, et al. Pharmacokinetic drug interactions with clopidogrel: updated review and risk management in combination therapy[J]. Ther Clin Risk Manag, 2015,11:449‑467. DOI: 10.2147/TCRM.S80437.
[49] Ma Y, Li S, Yang H, et al. Acid suppressants use and risk of atherosclerotic cardiovascular disease in middle‑aged and older adults[J]. Atherosclerosis, 2022,358:47‑54. DOI: 10.1016/j.atherosclerosis.2022.09.001.
[50] Lanas‑Gimeno A, Lanas Á. Adverse events in patients with cardiovascular disease taking proton pump inhibitors[J]. Expert Opin Drug Saf, 2024, 23(11):1381‑1391. DOI: 10.1080/14740338.2024.2409702.
[51] Li ZH, Zhong WF, Qiu CS, et al. Association between regular proton pump inhibitors use and cardiovascular outcomes: a large prospective cohort study[J]. Int J Cardiol, 2024,395:131567. DOI: 10.1016/j.ijcard.2023.131567.
[52] 袁耀宗. 酸相关性疾病的抑酸标准及抑酸药物选择[J]. 中华消化杂志, 2023, 43(9):579‑582. DOI: 10.3760/cma.j.cn311367‑20230719‑00013.
[53] Lee YJ, Je NK. Comparative effectiveness of potassium‑competitive acid blockers and proton pump inhibitors in dual antiplatelet therapy patients: a nationwide cohort study[J]. Int J Clin Pharm, 2025, 47(5):1204‑1214. DOI: 10.1007/s11096‑025‑01895‑2.
[54] Kagami T, Yamade M, Suzuki T, et al. Comparative study of effects of vonoprazan and esomeprazole on antiplatelet function of clopidogrel or prasugrel in relation to CYP2C19 genotype[J]. Clin Pharmacol Ther, 2018, 103(5):906‑913. DOI: 10.1002/cpt.863.
[55] Yang E, Ji SC, Jang IJ, et al. Evaluation of CYP2C19‑mediated pharmacokinetic drug interaction of tegoprazan, compared with vonoprazan or esomeprazole[J]. Clin Pharmacokinet, 2023, 62(4):599‑608. DOI: 10.1007/s40262‑023‑01228‑4.
[56] Lee PO, Choi SH, Heo SJ, et al. Safety and efficacy of tegoprazan in patients treated with dual antiplatelet therapy after drug‑eluting stent implantation for acute myocardial infarction [C]. ESC Congress 2025, Madrid, Spain,2025.
[57] Sachs G, Shin JM, Hunt R. Novel approaches to inhibition of gastric acid secretion[J]. Curr Gastroenterol Rep, 2010, 12(6):437‑447. DOI: 10.1007/s11894‑010‑0149‑5.
[58] Zhao C, Wang J, Xiao Q. Efficacy of teprenone for prevention of NSAID‑induced gastrointestinal injury: a systematic review and meta‑analysis[J]. Front Med (Lausanne), 2021,8:647494. DOI: 10.3389/fmed.2021.647494.
[59] Kak M. Rebamipide in gastric mucosal protection and healing: an Asian perspective[J]. World J Gastrointest Pharmacol Ther, 2025, 16(1):101753. DOI: 10.4292/wjgpt.v16.i1.101753.
[60] Oakland K, Chadwick G, East JE, et al. Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology[J]. Gut, 2019, 68(5):776‑789. DOI: 10.1136/gutjnl‑2018‑317807.
[61] Stanley AJ, Laine L. Management of acute upper gastrointestinal bleeding[J]. BMJ, 2019, 364:l536. DOI: 10.1136/bmj.l536.
[62] 国家卫生健康委员会脑卒中防治专家委员会房颤卒中防治专业委员会, 中华医学会心电生理和起搏分会, 中国医师协会心律学专业委员会. 达比加群特异性逆转剂依达赛珠单抗的临床应用专家共识[J]. 中华心律失常学杂志, 2020, 24(2):113‑122. DOI: 10.3760/cma.j.cn.113859‑20200309‑00057.
[63] Connolly SJ, Crowther M, Eikelboom JW, et al. Full study report of andexanet alfa for bleeding associated with factor Xa inhibitors[J]. N Engl J Med, 2019, 380(14):1326‑1335. DOI: 10.1056/NEJMoa1814051.
[64] Tomaselli GF, Mahaffey KW, Cuker A, et al. 2020 ACC expert consensus decision pathway on management of bleeding in patients on oral anticoagulants: a report of the American College of Cardiology Solution Set Oversight Committee[J]. J Am Coll Cardiol, 2020, 76(5):594‑622. DOI: 10.1016/j.jacc.2020.04.053.
[65] Laursen SB, Oakland K, Laine L, et al. ABC score: a new risk score that accurately predicts mortality in acute upper and lower gastrointestinal bleeding: an international multicentre study[J]. Gut, 2021, 70(4):707‑716. DOI: 10.1136/gutjnl‑2019‑320002.
[66] 中华消化杂志编辑委员会, 中华消化外科杂志编辑委员会. 急性非静脉曲张性上消化道出血多学科防治共识[J]. 中华消化杂志, 2019, 39(12):793‑799. DOI: 10.3760/cma.j.issn.0254‑1432.2019.12.001.
[67] Gralnek IM, Stanley AJ, Morris AJ, et al. Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline ‑Update 2021[J]. Endoscopy, 2021, 53(3):300‑332. DOI: 10.1055/a‑1369‑5274.
[68] 中国医师协会急诊医师分会, 中华医学会急诊医学分会, 全军急救医学专业委员会, 等. 急性上消化道出血急诊诊治流程专家共识[J]. 中国急救医学, 2021, 41(1):1‑10. DOI: 10.3969/j.issn.1002‑1949.2021.01.001
[69] Sostres C, Marcén B, Laredo V, et al. Risk of rebleeding, vascular events and death after gastrointestinal bleeding in anticoagulant and/or antiplatelet users[J]. Aliment Pharmacol Ther, 2019, 50(8):919‑929. DOI: 10.1111/apt.15441.
[70] Staerk L, Lip GY, 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:h5876. DOI: 10.1136/bmj.h5876.
[71] 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. DOI: 10.1111/bjh.14599.
[72] Forrest JA, Finlayson ND, Shearman DJ. Endoscopy in gastrointestinal bleeding[J]. Lancet, 1974, 2(7877):394‑397. DOI: 10.1016/s0140‑6736(74)91770‑x.
[73] Tavares C, Guimarães PO, Franken M, et al. Prasugrel or ticagrelor monotherapy vs dual antiplatelet treatment after percutaneous coronary intervention in acute coronary syndromes: a landmark analysis from the NEOMINDSET trial[J]. Eur Heart J, 2025. DOI: 10.1093/eurheartj/ehaf1050.
[74] Aoki T, Hirata Y, Yamada A, et al. Initial management for acute lower gastrointestinal bleeding[J]. World J Gastroenterol, 2019, 25(1):69‑84. DOI: 10.3748/wjg.v25.i1.69.
[75] Okumura K, Akao M, Yoshida T, et al. Low‑dose edoxaban in very elderly patients with atrial fibrillation[J]. N Engl J Med, 2020, 383(18):1735‑1745. DOI: 10.1056/NEJMoa2012883.