摘要
目的探讨阿加曲班用于高容量血液滤过的最佳抗凝剂量。方法采用病例交叉对照研究设计方案，选取10例肾功能不全患者分别进行3次（分别为A、B、C组）高容量血液滤过，抗凝方案：A组阿加曲班首剂量0．05mg·kg^-1·h^-1，追加量0．02mg·kg^-1·h^-1；B组阿加曲班首剂量0．07mg·kg^-1·h^-1，追加量0．04mg·kg^-1·h^-1；C组阿加曲班首剂量0．09mg·kg^-1·h^-1，追加量0．06mg·kg^-1·h^-1。检测治疗前及治疗后1、4和8h患者凝血指标，观察治疗结束时滤器凝血情况和结束后12h内患者的出血事件。结果3组患者均能顺利完成治疗，活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、国际标准化比值（INR）均较治疗前显著升高（P均〈0．05），除B、C组治疗1hTT、INR显著高于A组（P均〈0．05）外，其他各时间点间及组间比较差异均无统计学意义。治疗结束时C组患者滤器凝血程度与其他两组比较有加重趋势，3组患者治疗后均无出血事件发生。结论在抗凝剂量0．02～0．06mg·kg^-1·h^-1内，阿加曲班用于高容量血液滤过是安全有效的。
Objective To explore the ideal anticoagulation dose of argatroban during high volume hemofiltration. Methods Crossover study was designed and 10 patients were treated with high volume hemofiltration for 3 times. Three argatroban anticoagulation regimens were instituted accordingly. The dose of argatroban was 0.02 mg·kg^-1·h^-1 in regimen A, 0.04 mg·kg^-1·h^-1 in regimen B, and 0. 06 mg·kg^-1·h^-1 in regimen C. Coagulation parameters of patients on 1, 4 and 8 hours after the beginning of treatment were detected. Coagulation degree of the filter at the end of treatment and bleeding event during 12 hours after the end of treatment were observed. Results The value of activated partial thromboplastin time （APTT）, thrombin time （TT） and international normalized ratio （INR） after treatment were significantly higher than those before treatment （all P〈0. 05）. APTT during treatment showed no difference among three regimens. TT and INR of 1 hour after beginning of treatment in patients of regimen C and B were longer than those in regimen A （all P〈0.05）, there was no bleeding event in three regimens. Filter coagulation in regimen C at the end of treatment was more severious than other two regimens. Conclusion Argatroban dose in the range of 0.02 0. 06 mg·kg^-1·h^-1 is safe for anti-coagulation in high volume hemofiltration.
出处
《中国危重病急救医学》
CAS
CSCD
北大核心
2009年第4期240-242,共3页
Chinese Critical Care Medicine
关键词
高容量血液滤过
阿加曲班
抗凝剂量
high volume hemofiltration
argatroban
anticoagulation dose
