Background Anticoagulation treatments are an important aspect of hemodialysis; however,few reports have addressed these treatments.This investigation intends to increase the understanding of the current status and imp...Background Anticoagulation treatments are an important aspect of hemodialysis; however,few reports have addressed these treatments.This investigation intends to increase the understanding of the current status and improvements of hemodialysis-related anticoagulation treatments in China.Methods In this study,an epidemiological investigation was conducted that examined 842 patients in 2007 and 1 175patients in 2012 who underwent hemodialysis anticoagulation treatments in seven blood purification centers in northern Chinese cities.Results Heparin was the most commonly used anticoagulant,although the percentage of use of low-molecular-weight heparin （LMWH） increased from 26.5% in 2007 to 42.1% in 2012.In 2007,there were no significant differences in anticoagulant selection among either patients with various primary diseases or patients with hemorrhage,thrombosis,thrombocytopenia,or a low hemoglobin level.However,compared with patients with other diseases,significantly lower doses of LMWH were administered to patients with hypertension （55.5 U/kg vs.67.3 U/kg,P 〈0.05） or diabetes （58.5 U/kg vs.67.3 U/kg,P 〈0.05）,and patients with hemorrhage received lower doses of heparin than the other patients （61.6 U/kg vs.71.8 U/kg,P 〈0.01）.In 2012,patients with diabetic nephropathy （51.5% vs.36.5%,P 〈0.01）,hemorrhage （43.4% vs.31.7%,P 〈0.01）,or a hemoglobin level below 90 g/L （57.2% vs.37.1%,P 〈0.01） experienced significantly higher doses of LMWH administration; patients with hemorrhage received significantly reduced LMWH dosages （50.4 U/kg vs.57.8 U/kg,P 〈0.05）,and patients with thrombosis received significantly higher doses of heparin （73.8 U/kg vs.62.1 U/kg,P 〈0.01） or LMWH （57.8 U/kg vs.52.6 U/kg,P 〈0.05）.Antiplatelet drugs were administered to 20.4% of the examined patients in 2007 and 20.7% in 2012.In 2012,patients with hypertension （25.9% vs.18.5%,P 〈0.01） and thrombosis （36.6% vs.16.1%,P 〈0.01） had a higher rate of using antiplatelet drugs than patients with other primary diseases and complications.Patients receiving antiplatelet drugs also received higher doses of heparin than patients without using antiplatelet drugs （74.4 U/kg vs.65.9 U/kg,P 〈0.01）.However,the use of the drugs was not correlated with thrombocytopenia.The rate at which coagulation indices were determined increased from 45.7% in 2007 to 64% in 2012.Conclusion These findings suggested that hemodialysisrelated anticoagulation treatments in China have gradually become more standardized and individualized.展开更多
目的 研究脑血管病患者急性期 ( 10 d内 )及亚急性期 ( 4周内 )血浆低分子量肝素 ( L MWH)浓度 ,了解 L MWH样物质水平的自然变化趋势 ,并观察 L MMH治疗干预后体内 L MWH血浓度的变化以及出血副反应与浓度之间的关系。方法 应用发色...目的 研究脑血管病患者急性期 ( 10 d内 )及亚急性期 ( 4周内 )血浆低分子量肝素 ( L MWH)浓度 ,了解 L MWH样物质水平的自然变化趋势 ,并观察 L MMH治疗干预后体内 L MWH血浓度的变化以及出血副反应与浓度之间的关系。方法 应用发色底物法抗 FXa测定法对 84例急性脑血管病患者的血浆 L MWH浓度进行动态观察。结果 脑梗死患者与脑出血患者血浆 L MWH浓度在 0 .3～ 0 .4之间 ,相比无显著性差异 ;应用 L MWH治疗的脑梗死患者血浆 L MWH浓度高于非治疗组 ,且有显著差异性 ;血浆 L MWH浓度与出血副反应有一定的相关性。结论 监测血浆 L MWH浓度有益于防止出血副反应 ,为个体化给药提供了基础。展开更多
基金This work was supported by the grants from the Major State Basic Research Development Program of China （No.2013CB530800）,National Natural Science Foundation of China （No.81270819）,National Key Technology R＆D Program （No.2011BAI10B00） and Health Industry Scientific Research Special Project （No.201002010）.
文摘Background Anticoagulation treatments are an important aspect of hemodialysis; however,few reports have addressed these treatments.This investigation intends to increase the understanding of the current status and improvements of hemodialysis-related anticoagulation treatments in China.Methods In this study,an epidemiological investigation was conducted that examined 842 patients in 2007 and 1 175patients in 2012 who underwent hemodialysis anticoagulation treatments in seven blood purification centers in northern Chinese cities.Results Heparin was the most commonly used anticoagulant,although the percentage of use of low-molecular-weight heparin （LMWH） increased from 26.5% in 2007 to 42.1% in 2012.In 2007,there were no significant differences in anticoagulant selection among either patients with various primary diseases or patients with hemorrhage,thrombosis,thrombocytopenia,or a low hemoglobin level.However,compared with patients with other diseases,significantly lower doses of LMWH were administered to patients with hypertension （55.5 U/kg vs.67.3 U/kg,P 〈0.05） or diabetes （58.5 U/kg vs.67.3 U/kg,P 〈0.05）,and patients with hemorrhage received lower doses of heparin than the other patients （61.6 U/kg vs.71.8 U/kg,P 〈0.01）.In 2012,patients with diabetic nephropathy （51.5% vs.36.5%,P 〈0.01）,hemorrhage （43.4% vs.31.7%,P 〈0.01）,or a hemoglobin level below 90 g/L （57.2% vs.37.1%,P 〈0.01） experienced significantly higher doses of LMWH administration; patients with hemorrhage received significantly reduced LMWH dosages （50.4 U/kg vs.57.8 U/kg,P 〈0.05）,and patients with thrombosis received significantly higher doses of heparin （73.8 U/kg vs.62.1 U/kg,P 〈0.01） or LMWH （57.8 U/kg vs.52.6 U/kg,P 〈0.05）.Antiplatelet drugs were administered to 20.4% of the examined patients in 2007 and 20.7% in 2012.In 2012,patients with hypertension （25.9% vs.18.5%,P 〈0.01） and thrombosis （36.6% vs.16.1%,P 〈0.01） had a higher rate of using antiplatelet drugs than patients with other primary diseases and complications.Patients receiving antiplatelet drugs also received higher doses of heparin than patients without using antiplatelet drugs （74.4 U/kg vs.65.9 U/kg,P 〈0.01）.However,the use of the drugs was not correlated with thrombocytopenia.The rate at which coagulation indices were determined increased from 45.7% in 2007 to 64% in 2012.Conclusion These findings suggested that hemodialysisrelated anticoagulation treatments in China have gradually become more standardized and individualized.
文摘目的 研究脑血管病患者急性期 ( 10 d内 )及亚急性期 ( 4周内 )血浆低分子量肝素 ( L MWH)浓度 ,了解 L MWH样物质水平的自然变化趋势 ,并观察 L MMH治疗干预后体内 L MWH血浓度的变化以及出血副反应与浓度之间的关系。方法 应用发色底物法抗 FXa测定法对 84例急性脑血管病患者的血浆 L MWH浓度进行动态观察。结果 脑梗死患者与脑出血患者血浆 L MWH浓度在 0 .3～ 0 .4之间 ,相比无显著性差异 ;应用 L MWH治疗的脑梗死患者血浆 L MWH浓度高于非治疗组 ,且有显著差异性 ;血浆 L MWH浓度与出血副反应有一定的相关性。结论 监测血浆 L MWH浓度有益于防止出血副反应 ,为个体化给药提供了基础。
