阿加曲班在连续性肾脏替代治疗中的疗效观察

目的 观察阿加曲班在连续性肾脏替代治疗（continuous renal replacement therapy,CRRT）中的抗凝疗效观察以及不良事件.方法 33 例ICU行CRRT治疗患者按不同抗凝药物随机分为：阿加曲班组14例、低分子肝素组19例,监测患者活化部分凝血活酶时间,管路动脉压、静脉压、跨膜压等指标变化,观察管路滤器进行凝血分级评分及有无组织器官出血等不良反应.结果 阿加曲班组患者在治疗后4 h、8 h静脉端（activated partial thromboplastin time,APTT）高于同时点低分子肝素组患者（P＜0.05）,治疗后4 h阿加曲班组跨膜压低于同时点低分子肝素组,4 h置管出血评分阿加曲班组低于低分子肝素组（P＜0.05）.结论 CRRT时使用阿加曲班抗凝,在一定程度上取得了和低分子肝素相当的效果,并有较明确的监测指标,安全性相对较高.

Clinical observation of argatroban in continuous renal replacement therapy

Objective To investigate the anticoagulative efficacy and safety of argatroban in CRRT. Methods 33 patients of CRRT in ICU were divided into the experimental group （argatroban group） and the control group （LMWH group） by different anticoag- ulants. 14 patients were in argatroban group, 19 patients were in LMWH group. During the CRRT,the APTT,arterial vascular pressure, venous vascular pressure, TMP and the scores of the filters were monitored for observation if the other tissues and organs in patients bleed. Results There was no significant difference between the two groups in the scores of the filters. There were statistically signifi- cant （ P 〈 0.05 ） in 4 h and 8 h APTF （ venous vascular road）, TMP （4 h）, catheter bleeding score （4 h）. Conclusion Using ar- gatroban as an antieoagulation in CRRT had a considerable effect as LMWH and high security.