低分子肝素减少血液透析并发症的效果观察

Observation on effect of low molecular weight heparin on decrease of hemodialysis complications

目的探讨低分子肝素减少血液透析并发症的效果。方法终末期肾病患者80例,随机分为治疗组与对照组各40例,均采用血液透析治疗。透析期间对照组给予常规肝素抗凝,治疗组给予低分子肝素钠抗凝,连续治疗6个月,观察两组并发症发生情况及相关检测指标的变化。结果所有患者均完成透析与药物治疗,治疗期间无死亡情况发生。治疗组透析期间的高血压、低血压、心律失常、心绞痛、感染等并发症发生情况明显少于对照组(P<0.05)。治疗后两组的血浆超敏C反应蛋白、β2-微球蛋白、血肌酐、尿素氮均明显降低(P<0.05),而治疗组比对照组降低更显著(P<0.05)。结论低分子肝素在终末期肾病患者血液透析中的应用,能抑制体内炎症因子的表达,降低透析并发症的发生,从而有利于残余肾功能的恢复。

Objective To investigate the effect of low molecular weight heparin on decrease of hemodialysis complications.Methods 80 patients with end-stage renal disease were equally and randomly divided into treatment group and control group. All the patients were given hemodialysis treatment. During the hemodialysis, the control group received conventional anticoagulation with heparin, while the treatment group was given the anticoagulation with low molecular weight heparin for continuous treatment of six months. Observation was made in the incidence of complications and correlated detection indicators. Results All patients completed the dialysis and drug treatment, and there was no death occurred during the treatment. The incidence of hypertension, hypotension,arrhythmia, angina, infection and other complications in the treatment group during the dialysis was significantly lower than that in the control group（P 〈 0.05）. After the treatment, the plasma high-sensitivity C-reactive protein, β2-microglobulin values, serum creatinine,and blood urea nitrogen values of the two groups all significantly decreased（P 〈 0.05）, and the decreasing extent of the treatment group was more obvious than that of the control group（P 〈 0.05）. Conclusion The application of low molecular weight heparin to hemodialysis in patients with end-stage renal disease can inhibit the expression of inflammatory factors in vivo, reduce the incidence of dialysis complications, and therefore help to the recovery of residual renal function.