解放军医药杂志Issue(2)：77-81,88,6.DOI:10.3969/j.issn.2095-140X.2016.02.020
枸橼酸钠与阿加曲班在危重患者连续性静脉-静脉血液滤过治疗中的抗凝效果比较
Comparison of the Anticoagulant Effect between Sodium Citrate and Argatroban during Continuous Veno-ve-nous Hemofiltration Therapy for Critical Patients
杨嘉琳 1伍丽婵 1廖广园 1徐仲 1池凯仪 1高元妹1
作者信息
- 1. 510150 广州，广州医科大学附属第三医院重症医学科
- 折叠
摘要
Abstract
Objective To contrast the anticoagulant effect and safety between Sodium Citrate and Argatroban during continuous veno-venous hemofiltration ( CVVH) therapy for critical patients so as to optimize anticoagulation meth-od for critical patients during continuous blood purification. Methods A total of 134 critical patients during June 2014 and May 2015 were divided into Sodium Citrate group (n=59) and Argatroban group (n=75) according to the principle of random sampling. The general condition, CVVH therapeutic time, blood clotting function, routine blood and biochemi-cal examinations were recorded and compared in the two groups. Results The Argatroban dosage showed negative corre-lation with acute physiology and chronic health evaluation II ( APACHE II) score. There were significant differences in prothrombin time ( PT) , activated partial thromboplastin time ( APTT) , international normalized ratio ( INR) and fibrin-ogen ( Fb) before and after the treatment in Argatroban group ( P<0. 01 ) . There were significant differences in PT, APTT and INR values after the treatment between Argatroban and Sodium Citrate groups (P<0. 05, P<0. 01). No com-plicated hemorrhage was found in the two groups. The PH values before and after the treatment in the two groups were in the normal range, and the value after the treatment was significantly higher than that before the treatment in Argatroban group (P<0. 05). There were no significant differences in values of hematocrit (HCT) of leukocyte and red blood cell, serum creatinine, serum sodium and serum potassium before and after the treatment in the two groups (P>0. 05). There were significant differences in values of serum calcium in vivo and vitro after the filter between beginning and before the end of CVVH treatment in the Sodium Citrate group (P<0. 01). There was significant difference in serum calcium at the same time point after the filter between Argatroban and Sodium Citrate groups (P<0. 01). Conclusion Sodium Citrate and Argatroban are safe and effective in application of CVVH therapy for critical patients. Sodium Citrate is more suitable for the critical patients with bleeding risk, and Argatroban is safe and effective in treatment of patients with renal insuffi-ciency with rapid metabolism and easy monitoring, and therefore it is a good choice of anticoagulant drugs during CVVH therapy for critical patients.关键词
枸橼酸钠/阿加曲班/连续性血液净化/抗凝/危重症Key words
Sodium Citrate/Argatroban/Continue blood purification/Anticoagulant, Critically ill分类
医药卫生引用本文复制引用
杨嘉琳,伍丽婵,廖广园,徐仲,池凯仪,高元妹..枸橼酸钠与阿加曲班在危重患者连续性静脉-静脉血液滤过治疗中的抗凝效果比较[J].解放军医药杂志,2016,(2):77-81,88,6.
