比较低分子量肝素钠和柠檬酸钠对接受持续肾脏替代疗法的严重急性肾损伤患者的抗凝效果

IF 0.8 4区 医学 Q4 UROLOGY & NEPHROLOGY Iranian journal of kidney diseases Pub Date : 2024-08-20 DOI:10.52547/51nrj284
Yunxia Meng, Chengzhi Xie, Zheng Lin, Yuxiang Xie
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引用次数: 0

摘要

简介:连续性肾脏替代疗法(CRRT)能有效治疗急性肾损伤(AKI),但需要使用抗凝剂。本研究旨在比较低分子量肝素(LMWH)钠和枸橼酸钠对接受 CRRT 治疗的 AKI 患者的抗凝效果:方法:回顾性分析海南医学院第二附属医院(中国,海南)2020年1月至2023年1月接受CRRT治疗的150例重症AKI患者的病历。对照组 72 例患者使用 LMWH 钠作为抗凝剂,其余 78 例接受枸橼酸钠治疗的患者被纳入观察组。两组间比较的结果包括治疗前后的凝血指数、炎症因子和肾功能指数、滤器寿命和不良反应:治疗后,与对照组相比,观察组凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)水平明显降低,血小板(PLT)水平明显升高(P < .05),C反应蛋白(CRP)和白细胞介素-6(IL-6)水平明显降低(P < .05)。与对照组相比,观察组的过滤器使用寿命明显更长,不良反应总发生率明显更低(P < .05):结论:对于接受 CRRT 治疗的重度 AKI 患者,枸橼酸钠的抗凝效果优于 LMWH,可改善肾功能并延长过滤器的使用寿命,且不良反应较少。
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Comparison of Anticoagulant Effect of Low-Molecular-Weight Heparin Sodium and Sodium Citrate on Patients with Severe Acute Kidney Injury Treated by Continuous Renal Replacement Therapy.

Introduction: Continuous renal replacement therapy (CRRT) is effective in treating acute kidney injury (AKI), but it requires anticoagulants. The study was conducted to compare the anticoagulant effect of low-molecular-weight heparin (LMWH) sodium and sodium citrate on AKI patients treated by CRRT.

Methods: The medical records of 150 severe AKI patients treated by CRRT in the Second Affiliated Hospital of Hainan Medical College (China, Hainan) from January 2020 to January 2023 were analyzed retrospectively. LMWH sodium was administered as an anticoagulant for 72 patients in the control group, and the remaining 78 receiving sodium citrate were enrolled into the observation group. Outcomes compared between groups included coagulation indices, inflammatory factors and renal function indices prior and post therapy, filter lifespan and adverse reactions.

Results: Post therapy, in contrast to the control group, the observation group showed notably lower prothrombin time (PT) and activated partial thromboplastin time (APTT) levels and a notably higher platelet (PLT) level (P < .05) and presented notably lower C-reactive protein (CRP) and interleukin-6 (IL-6) levels (P < .05). In contrast to the control group, the observation group experienced a notably longer filter service life and a notably lower total incidence of adverse reactions (P < .05).

Conclusion: Sodium citrate had a better anticoagulant effect than LMWH for severe AKI patients treated by CRRT, improving renal function and filter longevity with fewer adverse effects.

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来源期刊
Iranian journal of kidney diseases
Iranian journal of kidney diseases UROLOGY & NEPHROLOGY-
CiteScore
2.50
自引率
0.00%
发文量
43
审稿时长
6-12 weeks
期刊介绍: The Iranian Journal of Kidney Diseases (IJKD), a peer-reviewed journal in English, is the official publication of the Iranian Society of Nephrology. The aim of the IJKD is the worldwide reflection of the knowledge produced by the scientists and clinicians in nephrology. Published quarterly, the IJKD provides a new platform for advancement of the field. The journal’s objective is to serve as a focal point for debates and exchange of knowledge and experience among researchers in a global context. Original papers, case reports, and invited reviews on all aspects of the kidney diseases, hypertension, dialysis, and transplantation will be covered by the IJKD. Research on the basic science, clinical practice, and socio-economics of renal health are all welcomed by the editors of the journal.
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