Hosokawa S, Oyamaguchi A, Yoshida O
Utano National Hospital, Kyoto, Japan.
Int J Artif Organs. 1989 Aug;12(8):544-8.
Heparin has generally been used as an anticoagulant during plasmapheresis. In this study plasma heparin levels were studied in nine patients before double filtration plasmapheresis (DFPP), 30, 60 and 120 minutes after the start of DFPP and at the end of DFPP. Prothrombin time (PT), activated partial thromboplastin time (APTT), bleeding time (BT), plasma fibrinogen levels, FDP and general blood cell examination (CBC) were measured pre and post DFPP. Heparin levels in plasma were lower than 1 (IU/ml) under the dosage of heparin nearly 40 IU/kg/h of heparin administered during DFPP. APTT before DFPP (36.5 +/- 8.2 sec) was nearly double the post-DFPP value (61.4 +/- 12.2 sec). In two patients who were given 30 IU/kg/h of heparin during DFPP, clotting occurred in the DFPP circuit. In conclusion, the optimized dosage of heparin was 40 IU per kg of body weight per hour during DFPP.
在血浆置换过程中，肝素通常被用作抗凝剂。在本研究中，对9例患者在双重滤过血浆置换（DFPP）前、DFPP开始后30、60和120分钟以及DFPP结束时的血浆肝素水平进行了研究。在DFPP前后测量了凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、出血时间（BT）、血浆纤维蛋白原水平、纤维蛋白降解产物（FDP）和全血细胞检查（CBC）。在DFPP期间给予近40 IU/kg/h肝素的剂量下，血浆中的肝素水平低于1（IU/ml）。DFPP前的APTT（36.5±8.2秒）几乎是DFPP后的两倍（61.4±12.2秒）。在DFPP期间给予30 IU/kg/h肝素的两名患者中，DFPP回路中发生了凝血。总之，DFPP期间肝素的最佳剂量为每千克体重每小时40 IU。
