低分子肝素对血液透析患者血小板活化状态的影响

Effect of low molecular weight hepain on mean platelet volume and alpha-granule membrane protein in patients treated with hemodlalysis

目的:研究低分子量肝素（ＬＭＷＨ）对血液透析（血透）患者血小板平均体积（ＭＰＶ）和ａ颗膜粒膜蛋白（ＧＭＰ－１４０）的影响。方法对４５例维持性血透患者分别使用ＬＭＷＨ和标准肝素（ＳＨ）抗凝，分别测定透析前、透析后１５、３０、６０、１２０、２４０分钟时活化的部分凝血酶时间（ＡＰＴＴ）和凝血酶时间（ＴＴ）及血小板计数（ＢＰＣ）、ＭＰＶ、ＧＭＰ－１４０并作比较。结果ＳＨ组ＡＰＴＴ和ＴＴ在透析１２０及２４０分钟时较之ＬＭＷＨ组显著延长（Ｐ均＜０．００１），透析１５分钟后ＳＨ组ＭＰＶ、ＧＭＰ－１４０较透析前及ＬＭＷＨ组有极显著增高（Ｐ均＜０．０１）。结论ＳＨ是引起血透过程中血小板活化的重要因素之一，ＬＭＷＨ能显著改善这种状况。

Objectives To investigate the effect of low molecular weight heparin on meanplatelet volume (MPV) and alpha-granule membrane protein (GMP-140) in patients with hemodialysis (HD). Methods 45 patients with HD were treated with same HD fashion and used either withlow molecular weighyt heparin (LMWH)or standard heparin (SH). The active partial thromboplasintime (APTT), thrombin time (TT) , BPC, MPV , GMP-140 were measured at prior-HD and 15,3O, 60, 120, 240 minutes after HD,respectively. Results APTT and TT were markedly prolongatedat 120, 240 minutes after HD in SH group than those in LMWH group (all P<0. 001). MPV andGMP-140 were much significantly higher at 15 minutes after HD in SH than those in LMWH group(all PRO. 01). Conclusion The SH might be an important factor contributing to platelet activation and that LMWH can improve platelet activation during HD.