阿加曲班与肝素类药物在血液透析抗凝治疗中的对比研究  

Argatroban and heparin drugs in anticoagulant therapy during hemodialysis:A comparative study

作　　者：刘佳[1] 赵君[1] 

机构地区：[1]海军总医院肾内科实验室,北京100048

出　　处：《军医进修学院学报》2012年第1期47-49,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的探讨阿加曲班在血液透析抗凝治疗中的疗效及安全性。方法 80例血液透析患者按不同抗凝药物随机分为:阿加曲班组30例、普通肝素组25例和低分子肝素组25例,于血液透析前后监测患者的活化部分凝血活酶时间(APTT)、PLT值及H-PF4抗体,并对血液透析器进行凝血分级评分,同时观察患者出血情况。结果阿加曲班组与肝素类组透析器凝血情况比较无统计学差异,APTT值、H-PF4抗体等与低分子肝素组比较无差异,但显著优于普通肝素组。阿加曲班组出血发生率0%,普通肝素组出血发生率为24%,低分子肝素组出血发生率为12%。结论血液透析时动脉端输入阿加曲班,抗凝效果与肝素类药物相当,且对体内凝血状态影响较小,很少并发出血,没有诱发HIT的风险。Objective To study the therapeutic effect and safety of argatroban and heparin drugs for patients receiving anticoagulant therapy during hemodialysis. Methods Eighty patients receiving hemodialysis were randomly divided into argatroban group（n=30）, common heparin group（n=25）, and low molecular weight heparin group（n=25） according to different anticoagulant drugs used for them. Their activated partial thromboplastin time（APTT）, PLT, and H-PF4 antibody were detected before and after hemodialysis. Coagulation in haemodialysers was scored and bleeding in the patients was observed. Results No difference was observed in coagulation in the haemodialysers between argatroban group and common heparin group, and in APTT, PLT, and H-PF4 antibody between argatroban group and low molecular weight heparin group. However, the APTT, PLT, and H-PF4 antibody were significantly better in argatroban group than in common heparin group. The incidence of hemorrhage was 0%, 24%, and 12%, respectively, in argatroban group, common heparin group, and low molecular weight heparin group. Conclusion Argatroban infusion from the artery is as effective as heparin drugs for patients receiving anticoagulant therapy during hemodialysis with less negative influence on their coagulation, hemorrhage and no risk of heparin-induced thrombocytopenia（HIT）.

关 键 词：血液透析 阿加曲班 低分子肝素钙 肝素 抗凝 

分 类 号：R982[医药卫生—药品]