肝素对接受人工肝治疗重型肝炎患者血小板的影响

Effects of different anticoagulant on the activity of platelets during treatment of severe hepatitis with artificial liver(ALSS)

目的探讨人工肝治疗重型肝炎时抗凝剂对血小板的影响。方法20例重型肝炎患者按治疗方法或药物不同分为两组:肝素组;低分子肝素(LM W H)组。肝素组和LM W H组均给予人工肝治疗,但所用抗凝剂不同。分别测定两组治疗前后血小板α颗粒膜蛋白(G M P-140)的变化,并行血小板电镜检查,以观察治疗前后血小板形态的变化。结果肝素组和LM W H组可引起血小板计数降低,但二者无显著性差异(P>0.05)。肝素组血小板α颗粒膜蛋白(GM P-140)增高,LM W H组则降低。治疗后肝素组可引起血小板结构改变如异常血小板增加、血小板活化等。结论LM W H应用于人工肝治疗重型肝炎患者时是安全的,且对患者的血小板影响较小。

Objective To investigate influence treatment of severe hepatitis with ALSS.Methods of different anticoagulant on patients platelets during According to different means of anticoagulant, twenty severe hepatitis patients were divided into 2 groups randomly： heparin group and LMWH group, and ALSS was given in both groups. The alpha-granule membrane protein （GMP-140） levels changes were evaluated,and electron microscopy was done for platelets before and after treatment in both groups respectively.Results Platelet hveh were significantly lowered after treatment in heparin and LMWH groups, but there was no significant defference（P〉0.05）.Alpha-granule membrane protein（GMP-140）levels increased in heparin group and decreased in LMWH group.There were more changes with platelets in heparin than LMWH after treatment,e.g the increase of abnormal and more activated platelets. Conclusion It is effective and safe when using LMWH in severe hepatitis patients during the treatment with artificial liver.