两种抗凝药物对高危出血倾向行连续血液净化患者的凝血、电解质、血脂和炎症因子影响的比较

Comparison of the influence of two anticoagulants on blood clotting, electrolyte, blood lipids and inflammatory factors in patients with high-risk hemorrhage prone to continuous blood purification

目的比较枸橼酸钠抗凝与低分子肝素钠抗凝对高危出血倾向患者连续血液净化(CBP)的凝血、电解质、血脂和炎症因子的影响。方法收集2015年1月～2017年3月在我院行CBP治疗的125例危重症患者,根据入院顺序随机分为观察组(65例)和对照组(60例)。观察组采用枸橼酸钠抗凝,对照组采用低分子肝素钠抗凝。比较两组患者的凝血、血肌酐(SCr)、尿素氮(BUN)、电解质和炎症因子。结果观察组治疗后的血SCr和BUN明显低于对照组,滤器寿命明显长于对照组,活化部分凝血活酶时间(APTT)短于对照组,差异均有统计学意义(P<0.05)。结论与低分子肝素钠抗凝相比,枸橼酸钠抗凝对高危出血患者凝血影响较小,能够降低患者外周血SCr、BUN及延长滤器使用寿命。

Objective To compare the influence of Sodium Citrate anticoagulation and Low Molecular Weight Heparin Sodium on blood clotting, electrolyte, blood lipid and inflammation factor in patients with high-risk hemorrhage prone to continuous blood purification (CBP). Methods A total of 125 cases of critically ill patients treated with CBP in our hospital from January 2015 to March 2017 were collected and randomly divided into the observation group (65 cases) and the control group (60 cases) according to the time of admission. The observation group received Sodium Citrate anticoagulation, while the control group received Low Molecular Weight Heparin Sodium anticoagulation. The blood clotting, serum creatinine (SCr), blood urea nitrogen (BUN), electrolyte, blood lipid and inflammation factor were compared between the two groups. Results After treatment, the levels of SCr and BUN of the observation group were obviously lower than those of the control group, the life of filter in the observation group was significantly longer than that in the control group, and the activated partial clotting enzyme (APTT) in the observation group was shorter than that in the control group, there were significant differences (P<0.05). Conclusion Compared with Low Molecular Weight Heparin Sodium anticoagulation, Sodium Citrate anticoagulation group has little effect on coagulation index in high risk hemorrhage patients, which can reduce the level of SCr and BUN in peripheral blood of patients and prolong the service life of filters.