血液净化体外循环凝血机制及抗凝策略的研究新进展  

Recent advances in coagulation mechanism and anticoagulation strategy of extracorporeal circulation in blood purification

作　　者：何喜梅 万立平 李甜[1,2] 王学良 苑书婷 席春生 HE Xi-mei;WAN Li-ping;LI Tian;WANG Xue-liang;YUAN Shu-ting;XI Chunsheng(The First Clinical Medical College,Gansu University of Chinese Medicine,Lanzhou 730000,China;Department of Nephrology,the 940th Hospital of Joint Logistic Support Force of PLA,Lanzhou 730050,China)

机构地区：[1]甘肃中医药大学第一临床医学院,兰州730000 [2]中国人民解放军联勤保障部队第九四〇医院肾脏病科,兰州730050

出　　处：《中国血液净化》2024年第10期771-774,共4页Chinese Journal of Blood Purification

基　　金：甘肃省卫生健康行业科研计划项目(GSWSKY2022-51);联勤保障部队第九四〇医院专项课题(2022yxky017)。

摘　　要：血液净化在清除体内毒素和废物、维持体内电解质和酸碱平衡方面具有重要性,这对提高患者的生存时间和生活质量至关重要。然而,当血液与滤器或管路接触时,会迅速引发凝血反应,导致治疗提前中断、透析充分性下降,并增加凝血系统活化、凝血因子消耗和免疫炎症反应的风险,同时还会增加滤器堵塞、出血和血栓形成等与凝血有关并发症的风险。随着血液净化技术的不断发展,人们对体外循环凝血机制进行了更深入的探索,并对安全有效的抗凝策略进行了研究。因此,本综述对当前设备表面凝血机制研究的最新进展进行了全面总结,并对凝血通路抑制、膜表面修饰与改性以及体外回路改进等系列进展进行了简要归纳。Blood purification is an important treatment modality to clear toxins and other wastes from the body and to maintain electrolyte and acid-base balance,critical for patients’survival and quality of life.However,blood quickly develops a coagulation reaction when it contacts filters and tubes,which lowers the adequacy of hemodialysis or even interrupts the hemodialysis.This reaction may also trigger the activation of coagulation system,leading to consumption of clotting factors,immune-inflammatory reactions,filter blockage,bleeding,thrombus formation,and other coagulation-related complications.With the advances of blood purification technology,the mechanisms of coagulation in the extracorporeal circulation and the effective anticoagulation strategies have been widely investigated.This review comprehensively summarizes the recent advances in the mechanisms of blood coagulation on equipment surfaces,and also briefly reviews the recent advances in inhibition of coagulation pathways,modification or engineering of membrane surfaces,and improvement of extracorporeal circuits.

关 键 词：血液净化 凝血机制 抗凝策略 

分 类 号：R459.5[医药卫生—治疗学]