Von Bonsdorff M, Stiekema J, Harjanne A, Alapiessa U
Fourth Department of Medicine, Helsinki University Central Hospital, Finland.
Int J Artif Organs. 1990 Feb;13(2):103-8.
A low molecular weight heparinoid (Org 10172) was compared with unfractionated heparin in 36 patients on chronic hemodialysis in an open randomized cross-over study with three anti-coagulant treatment regimens for a single hemodialysis session. The anti-coagulant regimens were: a) standard heparin (3250-4750 I.U. heparin at start of hemodialysis followed by continuous infusion of 2000-2700 I.U. per hour); b) Org 10172 administered as a single intravenous bolus of 2400 anti-Xa units at start of dialysis; c) Org 10172 administered as a single bolus of 3200 anti-Xa units at start of dialysis. Plasma anti-Xa activity during hemodialysis was highest in regimen; d) and significantly lower when heparin was used. Mean beta-thromboglobulin concentrations changed to the same extent in the three groups. Plasma platelet factor 4 concentrations were higher after the use of heparin. The extracorporeal circuit was maintained patent in all groups; the volume of blood retained in the dialyzers did not differ markedly. Org 10172 proved safe and its anticoagulant effect was sufficient at the dose levels studied.
在一项开放性随机交叉研究中,对36例慢性血液透析患者使用低分子量类肝素(Org 10172)与普通肝素进行比较,针对单次血液透析 session 设置了三种抗凝治疗方案。抗凝方案如下:a)标准肝素(血液透析开始时给予3250 - 4750国际单位肝素,随后以每小时2000 - 2700国际单位持续输注);b)透析开始时静脉单次推注2400抗Xa单位的Org 10172;c)透析开始时静脉单次推注3200抗Xa单位的Org 10172。血液透析期间血浆抗Xa活性在方案d中最高;使用肝素时则显著降低。三组中平均β-血小板球蛋白浓度变化程度相同。使用肝素后血浆血小板因子4浓度更高。所有组的体外循环均保持通畅;透析器中留存的血液量无明显差异。在研究的剂量水平下,Org 10172被证明是安全的,其抗凝效果足够。