Maurin N, Kierdorf H
Abteilung Innere Medizin II, Klinikums der Rheinisch-Westfälischen Technischen Hochschule Aachen.
Klin Wochenschr. 1988 Mar 15;66(6):246-9. doi: 10.1007/BF01748164.
The purpose of our study was to check whether the dosage recommended for the low molecular weight heparin tested here, i.e., 50% of the corresponding unfractionated heparin dose, is adequate to prevent clot formation in the extracorporeal system. Sixteen dialysis treatments of 4-5 h were given to each of six chronic dialysis patients. In dialyses 1, 2, 15 and 16 unfractionated heparin (initial dose 35 IU/kg, continuous dose 20 IU/kg/h) was given, and in dialyses 3-14 low molecular weight heparin (initial dose 17.5 anti-Xa U/kg, continuous dose 10 anti-X U/kg/h). At these dose levels of low molecular weight heparin, clot formation occurred in the extracorporeal system in five of the six patients, despite the fact that the plasma anti-Xa level of 0.5 U/ml recommended by the manufacturer had been attained. For this reason the continuous dose of low molecular weight heparin had to be raised to approx. 80% of the corresponding continuous dose of unfractionated heparin. A plasma anti-Xa level of 0.7 U/ml is necessary to prevent extracorporeal clot formation.
我们研究的目的是检验本文所测试的低分子量肝素的推荐剂量（即相应普通肝素剂量的50%）是否足以防止体外循环系统中血栓形成。对6名慢性透析患者每人进行了16次4至5小时的透析治疗。在第1、2、15和16次透析中给予普通肝素（初始剂量35 IU/kg，持续剂量20 IU/kg/h），在第3至14次透析中给予低分子量肝素（初始剂量17.5抗Xa U/kg，持续剂量10抗X U/kg/h）。在这些低分子量肝素剂量水平下，6名患者中有5名体外循环系统中出现了血栓形成，尽管已达到制造商推荐的0.5 U/ml的血浆抗Xa水平。因此，低分子量肝素的持续剂量不得不提高到相应普通肝素持续剂量的约80%。需要0.7 U/ml的血浆抗Xa水平来防止体外血栓形成。
