阿加曲班在中心静脉置管诱导血液透析中的应用  

Anticoagulative Effect of Argatroban in Induced Hemodialysis Patients with Central Venous Catheter

作　　者：石明[1] 程晖[1] 刘红燕[1] 邱昌建[1] 贾汝汉[1] 

机构地区：[1]武汉大学人民医院肾内科,武汉430060

出　　处：《中国中西医结合肾病杂志》2008年第7期609-611,共3页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：湖北省自然科学基金资助项目(No.2007ABA356)

摘　　要：目的:探讨阿加曲班在中心静脉置管诱导血液透析中的抗凝效果和出血事件。方法:将104例患者随机分为普通肝素组和阿加曲班组。所有患者在置入右侧颈内静脉置管后接受连续2d的2次诱导血液透析,阿加曲班抗凝剂量按1.5μg·kg-1·min-1)持续由动脉端给予。测定透析前后患者的血常规、肝肾功能、电解质和凝血功能并采用评分方法评价透析器凝血和置管处出血和血肿情况。结果:普通肝素组和阿加曲班组透析器凝血情况无明显差异,但是颈内静脉置管处出血情况,阿加曲班组较普通肝素组显著降低(P<0.05),在相同透析器凝血情况下,阿加曲班组APTT和ACT值较肝素组低(P<0.01)。在透析1h时同时检测阿加曲班组动脉端和静脉端APTT值,两者有统计学差异(P<0.05)。结论:在达到同样抗凝效果时,阿加曲班较普通肝素所需的APTT和ACT值更低,而且阿加曲班体外的抗凝作用强于体内,因此阿加曲班可能成为血液透析一种新型的替代抗凝药物。Objective： To evaluate the effect of argatroban in induced hemodialysis patients with central venous catheter. Methods-One hundred and four patients at CKD stage 5 were randomly divided into 2 groups. Unfractional Heparin （UFH group） and argatroban group （ARG group）. All the patients received twice induced hemodialysis at the 2nd and 3rd hour. The blood analysis,blood chemical analysis,activated partial thromboplastin time （APTT） and activated clotting time （ACT） was measured before and during hemodialysis. In ARG group, arterial and venous APTT and ACT were measured simultaneously. Results： There is no difference in clotting condition between the two groups while less hemorrhage occurred in ARG group. Both APTT and ACT were significantly shorter in the ARG group compared with those in UFH group. In ARG group the APTT and ACT were shorter in arteria compared with those in veins. Conclusion：To obtain the same anticoagulation effect in induced hemodialysis, the APTT and ACT are shorter with argartroban than unfractional heparin. Argatroban might be a new ahernative anticoagulation agent in hemodialysis.

关 键 词：阿加曲班 中心静脉置管 血液透析 

分 类 号：R692.5[医药卫生—泌尿科学]