Gerlach A T, Pickworth K K, Seth S K, Tanna S B, Barnes J F
Department of Pharmacy, Ohio State University Medical Center, Columbus 43210, USA.
Pharmacotherapy. 2000 Jul;20(7):771-5. doi: 10.1592/phco.20.9.771.35210.
To compare the frequency of bleeding complications from enoxaparin in patients with normal renal function versus patients with renal insufficiency.
Retrospective chart review.
University-based tertiary care center.
One hundred six patients who received two or more doses of enoxaparin.
Total bleeding complications occurred in 22% of patients with normal renal function and 51% with renal insufficiency (p<0.01). Major bleeds were also significantly different, 2% and 30%, respectively (p<0.001). No patients with normal renal function were given fresh-frozen plasma or packed red blood cells, whereas in those with renal insufficiency, 13% and 32%, respectively, received these products (p<0.01).
Enoxaparin may have resulted in increased bleeding complications and use of blood products in patients with renal insufficiency. Prospective studies need to be conducted to define the drug's role and dosage adjustments in these patients.
比较肾功能正常患者与肾功能不全患者使用依诺肝素后出血并发症的发生率。
回顾性病历审查。
大学附属三级医疗中心。
106例接受两剂或更多剂依诺肝素治疗的患者。
肾功能正常患者的总出血并发症发生率为22%，肾功能不全患者为51%（p<0.01）。严重出血情况也有显著差异，分别为2%和30%（p<0.001）。肾功能正常的患者均未接受新鲜冰冻血浆或浓缩红细胞治疗，而肾功能不全的患者中，分别有13%和32%接受了这些治疗（p<0.01）。
依诺肝素可能导致肾功能不全患者出血并发症增加及血液制品使用增多。需要进行前瞻性研究以明确该药物在这些患者中的作用及剂量调整。
