< International Circulation>:Venous thromboembolism is the most frequent thromboembolic disease and there has been some progress in therapy of this condition. Could you give us an introduction to the treatment of this condition?
静脉血栓栓塞是最常见的血栓栓塞性疾病，它的治疗也已经取得一定的进展。您可以给我们介绍一下它的治疗吗？

    Prof. Mannucci: None of these drugs I just mentioned are yet licensed for acute venous thrombolism but there have already been phase III studies published in major journals. When we need to treat this condition we can use LMWH followed by oral anticoagulants， which is very effective and can reduce thromboembolism by 60% or more. However， there are some problems with this treatment. For example， you must switch drugs because to get an immediate effect you can not give vitamin K antagonists and you must give LWMH for 3~4 days. This is not a major problem but since these conditions are often treated at home it is not convenient to give large subcutaneous doses twice per day. The problem comes when you switch to oral anticoagulants because you must control the dosage through prothrombin time due to interaction with food， interaction with other drugs， and polymorphism. The use of vitamin K antagonists is a time-honored treatment and is very effective but the issue of monitoring creates some problems. There is not so much a problem when you only need to treat them for 3 months but when you must treat them for 6 months or indefinitely then vitamin K antagonists create problems of compliance due to difficulties such as having to go to the hospital for testing. Thus， having a drug that you can start with and continue until it is no longer needed is advantageous and rivaroxiban and dabigatran have these features. However， they are not yet licensed for this indication. The main advantage will be that you use only one drug and not the bridging between LMWH or fractionated   heparin and oral anticoagulants because these drugs are rapidly effective so you do not need to give a drug like LMWH because you have an effect with these drugs within a few hours.
     我之前提到的那些药物都没有被批准用于急性静脉血栓形成，但根据专业期刊报道，已经在进行III期临床研究。治疗静脉血栓形成时，我们可以使用LMWH继以口服抗凝药物，这是非常有效的，可以使血栓栓塞减少60％甚至更多。但是，这一治疗方法也存在一些问题。例如，为了即时起效不能使用维生素K拮抗剂而必须改用LWMH 3-4天。但最主要的问题并不是这个，而是由于这种情况经常是在家中进行治疗的，所以不便于给予每天两次的大剂量皮下注射。改为口服抗凝血药物时的问题是由于存在与食物、其他药物的相互作用以及患者的个体性差异，必须根据凝血酶原时间调整剂量。维生素K拮抗剂是治疗静脉血栓形成，经典且非<

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