摘要
目的 评价血透前注射单剂量低分子量肝素(LMWH)与持续输注普通肝素 (SH)对复用透析器效率的影响。方法 对 30例慢性透析患者进行随机交叉对照研究 ,观察第 1、4次透析的透析器纤维包裹容量 (FBV)、透析前血球压积 (HCT)及透析 2h尿素氮、肌酐清除率 ;另外 ,利用生色底物法测定透析 0h、2h、4h血浆肝素抗 Fxa水平。结果 同SH组比 ,LMWH组透析器复用次数增加 (P <0 0 5 ) ,第 4次复用透析器FBV及透析 2h尿素氮、肌酐清除率无下降 (P >0 0 5 ) ,SH组则下降 (P <0 0 5 ) ,透析 2h两组血浆肝素活性抗 Fxa水平差异无显著性 (P >0 0 5 ) ,透析 4hLMWH组高于SH组 (P <0 0 5 )。结论 透析前单剂量注射LMWH能有效地保护复用透析器清除率 。
Objective To evaluate the efficiency of low molecular weight heparin(LMWH, fraxiparine) given as a single predialysis bolus injection with reused dialyzers in comparison with standard heparin(SH) administered with a continuous infusion. Methods 30 hemodialysis patients were studied in a radomized crossover fashion. Dialyzers fibrer bundle volumes(FBV), predialysis hemocrit and 2 h clearance of urea, creatinine were observed in the first, the fourth dialysis. The plasma heparin activities(anti Fxa levels) were measured by the chromogenic substrate assay in 0 h, 2 h, 4 h of dialysis. Results Significant increase ( P< 0 05) was seen in the number of dialyzer reuse in LMWH group compared with SH group; there was not significant decrease in dialysis FBV as well as 2 h clearance of urea, creatinine ( P> 0 05); in addition, the plasma heparin activity(anti Fxa levels) were comparable in both groups after 2 h of dialysis, however, they were significantly higher after 4 h in the LMWH than those in the SH group ( P< 0 05). Conclusion LMWH as a single bolus dose can prevent decrease in dialyzer clearance. It is clinically worthy of further popularity.
出处
《安徽医科大学学报》
CAS
2001年第2期121-123,共3页
Acta Universitatis Medicinalis Anhui
关键词
肝素
投药
剂量
低分子量肝素
血液透析
heparin/administration and dosage, low molecular weight heparin
hemodialysis
