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目的:观察低相对分子质量肝素(LMWH)钠应用于血液透析的抗凝疗效和安全性.方法:3O例稳定的尿毒症维持性血透患者,随机分为未分组肝素(UFH)组和LMMH组.UFH首剂4～6mg/kg,追加6～8mg/h,透析结束前0.5h停用.LMWH3200IU透前一次性iv.结果:LMWH组透析器内纤维血栓形成显著较少;用药2和4h血浆aXa活性显著较高,且4与2h比较仅轻度下降;用药后2h血浆部分活化凝血激酶时间(APTT)显著延长,4h后恢复至正常范围,但UFH组用药后2和4h均显著延长,为LMWH组的2倍余;用药后4h血浆D-二聚体浓度显著升高.结论;LMWH应用于血透时具有较UFH更好的抗拴作用,且有明确的纤溶作用,透析4.5～5h仅需1次用药.
Abstract：AIM:To observe the efficacy and safety of low molecular weight heparin——inhemodialysis. METHODS: Thirty stable uremic patients were randomly divided into unfrac-tionated heparin (UFH)and low molecular weight heparin (LMWH) group. Intravenous UFH of 4-6 mg/kg were given before each hemodialysis and then added through arterial line at the dose of 6-8 mg/h. Intravenous LMWH of 3 200 IU were given before each hemodialysis. RESULTS: Less clot formation in dialyzer; higher plasma anti-Xa levels and maintained persistently;elevated plasma D dimer levels were observed in LMWH group than in UFH group. Significantly prolonged plasma activated partial thromboplastin time (APTT) 2 h after the dose were also observed but returned to normal range 2 h later in LMWH groug. CONCLUSION: LMWH have a better antithrombotic effect than UFH in hemodialysis. Once dose of LMWH is enough for 4. 5-5 h hemodialysis.
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基本信息:
DOI：10.19577/j.cnki.issn10074406.1999.02.002
中图分类号:R459.5
引用信息:
[1]丁小强,鲍晓荣,吴兆龙.低相对分子质量肝素钠用于血液透析抗凝的疗效和安全性[J].中国临床药学杂志,1999(02):70-73.DOI:10.19577/j.cnki.issn10074406.1999.02.002.
1999-04-15
1999-04-15