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肝素和阿司匹林对小儿肾移植血管血栓形成的保护作用。

Protective effect of heparin and aspirin against vascular thrombosis in pediatric kidney transplants.

作者信息

Esfandiar Nasrin, Otukesh Hasan, Sharifian Mostafa, Hoseini Rozita

机构信息

Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Kidney Dis. 2012 Mar;6(2):141-5.

Abstract

INTRODUCTION

This study was conducted to evaluate preventive effect of a combination of heparin and aspirin on vascular thrombosis and kidney transplant outcomes of pediatric kidney transplant recipients.

MATERIALS AND METHODS

Twenty-four pediatric kidney transplant recipients received heparin, 50 U/kg, every 8 hours for 7 postoperative days, and aspirin, 5 mg/kg, thrice a week from day 3 of transplantation for 3 months. These patients were compared with a matched group of pediatric kidney allograft recipients in terms of development of thrombosis and serum creatinine level at 1 year postoperation.

RESULTS

The mean age of patients was 9.4 ± 3.2 years. No vascular thrombosis was developed among the 24 patients with anticoagulant therapy, while in the control group, 5 grafts (7.9%) developed thrombosis (P = .19). Serum creatinine levels at 1 year were lower in the children with anticoagulant therapy as compared with the controls (P = .02).

CONCLUSIONS

Our study revealed a reduction in kidney allograft thrombosis incidence in children who received heparin and aspirin after transplantation, which was clinically important although the difference was not statistically significant. Lower serum creatinine levels as compared with a historical cohort group were seen 1 year after transplant surgery. These findings are required to be confirmed by further studies.

摘要

引言

本研究旨在评估肝素与阿司匹林联合使用对小儿肾移植受者血管血栓形成及肾移植结局的预防效果。

材料与方法

24例小儿肾移植受者术后7天内每8小时接受一次50 U/kg的肝素治疗,自移植第3天起每周3次、每次5 mg/kg的阿司匹林治疗,持续3个月。将这些患者与匹配的小儿肾移植受者组在术后1年的血栓形成情况及血清肌酐水平方面进行比较。

结果

患者的平均年龄为9.4±3.2岁。接受抗凝治疗的24例患者中未发生血管血栓形成,而在对照组中,有5个移植物(7.9%)发生血栓形成(P = 0.19)。与对照组相比,接受抗凝治疗的儿童术后1年的血清肌酐水平较低(P = 0.02)。

结论

我们的研究显示,移植后接受肝素和阿司匹林治疗的儿童肾移植血栓形成发生率降低,尽管差异无统计学意义,但在临床上具有重要意义。移植手术后1年,与历史队列组相比,血清肌酐水平较低。这些发现需要进一步研究予以证实。

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