血液透析应用低分子量肝素和普通肝素相关实验参数比较

目的 研究血液透析应用低分子量肝素和普通肝素抗凝时相关实验参数的变化。方法 22例血液透析的尿毒症患者分别用低分子量肝素和普通肝素抗凝,监测指标包括抗因子Xa活性(AFXa)、凝血酶时间(TT)和活化部分凝血活酶时间(APTT)。结果 应用低分子量肝素抗凝时APTT、TT在透析过程中延长不明显(P>0.05),普通肝素组APTT、TT于透析30分钟及透析结束时明显延长,甚至部分血液不凝。低分子量肝素组透析结束时血浆抗FXa活性较透析前有显著性差异,且透析后30分钟及透析结束时均明显高于普通肝素组(P<0.001)。结论 低分子量肝素抗凝作用同APFF、TT无一定相关,低分子量肝素抗凝作用可由抗-FXa水平作为可靠根据,低分子量肝素在血液透析抗凝过程中比普通肝素更为安全、有效。

The laboratory parameter study of low molecular weight heprin and unfractionated heparin in hemodialysis

Objective To study the laboratory parameter of low molecular weight heprin (LMWH) and unfractionat-ed heparin (UFH) in hemodialysis. Methods 22 patients with chronic renal failure were given LMWH and UFM antico-agulanition separately. The Anti - FXa. thrombin time (TT) and activated partial thromboplastin time (APTT) of these two kinds of anticoagulanition were detected and compared. Results The APTT and TT in LMWH group did not prolong significantly in hemodialysis, while they prolonged significantly in UFH group at 30 minutes after hemodialysis and at the end of hemodiylsis. The value of Anti - FXa in LMWH group had significant difference between before and in hemodialysis , and it was significantly higher in hemodialysis than those of UFH group. Conclusion LMWH has no effect on APTT and TT, but it has the effect on Anti - FXa. LMWH has more effecacy and safety in hemodialysis than UFH.