不同首剂量阿加曲班在出血倾向连续性肾脏替代治疗患者中的应用

摘要

Objective To investigate the anticoagulant effect of different initial dose of argatroban in patients with hemorrhage tendency undergoing continuous renal placement therapy (CRRT).Methods One hundred and fortyone patients of hemorrhage tendency undergoing CRRT were divided into four groups according to the different initial dose:0 μg/kg group,20 μg/kg group,30 μg/kg group and 40 μg/kg group,each group maintenance was 24 μg/(kg · h).The activated partial thromboplastin time(APTT) was observed before,during and after treatment.The coagulation hemofilter and blood pipeline were observed during and after treatment.Results The change of APTT in 30 μg/kg group kept relatively stable and APTT maintained between 1.5 and 2.5 times than before argatroban,venous pressure was stable and anticoagulant was effective.Conclusion The initial dose in 30 μg/kg group with CRRT is successful withnot coagulation and bleeding trends.%目的 观察不同首剂量阿加曲班在出血倾向连续性肾脏替代治疗(CRRT)患者中的抗凝效果.方法 选择141例接受CRRT治疗的患者,根据不同首剂量将患者分为0 μg/kg组、20 μg/kg组、30 μg/kg组、40μg/kg组,各组维持量均为24 μg/(kg·h),观察各组治疗前、中、治疗结束前患者活化部分凝血活酶时间(APTT);治疗中、治疗结束时血滤器、血路管凝血情况.结果 30 μg/kg组APTT水平变化较平稳,在体外基本维持APTT于使用阿加曲班注射液前1.5～2.5倍左右,CRRT治疗时静脉压稳定而且抗凝效果好.结论 首剂量30 μg/kg阿加曲班可使CRRT顺利进行,且无凝血及出血倾向.