Department of Nephrology, Guangdong General Hospital, Guangzhou, PR China.
Blood Purif. 2010;29(4):375-82. doi: 10.1159/000314649. Epub 2010 May 20.
Thrombocytopenia is a common complication in patients receiving continuous veno-venous hemofiltration (CVVH) in the intensive care unit. The hemofilter itself plays an important role in the genesis of thrombocytopenia. The present study was undertaken to test whether there were differences in platelet loss and activation during CVVH with a polysulfone (PS) hemofilter or a cellulose triacetate (CTA) dialyzer. 96 patients with thrombocytopenia and acute kidney injury requiring CVVH were randomly assigned to four groups receiving low-molecular-weight heparin (LMWH) PS (n = 24), LMWH CTA (n = 24), no anticoagulation PS (n = 24), and no anticoagulation CTA (n = 24), respectively. We found a significant decrease in platelet counts, but an increased platelet activation with the PS hemofilter in patients who received no anticoagulation. There was no significant decrease in platelet counts and activation in the CTA group. The cellulose membranes could be an effective alternative to the standard synthetic membranes in patients at high risk for thrombocytopenia during CVVH.
血小板减少症是重症监护病房中接受连续静脉-静脉血液滤过（CVVH）治疗的患者常见的并发症。血液滤器本身在血小板减少症的发生中起着重要作用。本研究旨在测试在使用聚砜（PS）血液滤器或纤维素三醋酸酯（CTA）透析器进行 CVVH 时，血小板丢失和激活是否存在差异。96 名血小板减少症和需要 CVVH 的急性肾损伤患者被随机分配到四组，分别接受低分子肝素（LMWH）PS（n = 24）、LMWH CTA（n = 24）、无抗凝 PS（n = 24）和无抗凝 CTA（n = 24）。我们发现，在未接受抗凝治疗的患者中，使用 PS 血液滤器会导致血小板计数显著下降，但血小板活化增加。在 CTA 组中，血小板计数和活化没有显著下降。在 CVVH 期间有发生血小板减少症高风险的患者中，纤维素膜可以作为标准合成膜的有效替代品。
