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低分子肝素钠与枸橼酸钠对连续性肾脏替代治疗的重症急性肾损伤患者抗凝效果比较。

Comparison of Anticoagulant Effect of Low-Molecular-Weight Heparin Sodium and Sodium Citrate on Patients with Severe Acute Kidney Injury Treated by Continuous Renal Replacement Therapy.

机构信息

Division 1 of Critical care Medicine, The Second Affiliated Hospital of Hainan Medical College, No.368, Yahai Avenue, Longhua District, Haikou570100, Hainan Province, China.

出版信息

Iran J Kidney Dis. 2024 Aug 20;18(4):221-226. doi: 10.52547/51nrj284.

DOI:10.52547/51nrj284
PMID:39423094
Abstract

INTRODUCTION

Continuous renal replacement therapy (CRRT) is effective in treating acute kidney injury (AKI), but it requires anticoagulants. The study was conducted to compare the anticoagulant effect of low-molecular-weight heparin (LMWH) sodium and sodium citrate on AKI patients treated by CRRT.

METHODS

The medical records of 150 severe AKI patients treated by CRRT in the Second Affiliated Hospital of Hainan Medical College (China, Hainan) from January 2020 to January 2023 were analyzed retrospectively. LMWH sodium was administered as an anticoagulant for 72 patients in the control group, and the remaining 78 receiving sodium citrate were enrolled into the observation group. Outcomes compared between groups included coagulation indices, inflammatory factors and renal function indices prior and post therapy, filter lifespan and adverse reactions.

RESULTS

Post therapy, in contrast to the control group, the observation group showed notably lower prothrombin time (PT) and activated partial thromboplastin time (APTT) levels and a notably higher platelet (PLT) level (P < .05) and presented notably lower C-reactive protein (CRP) and interleukin-6 (IL-6) levels (P < .05). In contrast to the control group, the observation group experienced a notably longer filter service life and a notably lower total incidence of adverse reactions (P < .05).

CONCLUSION

Sodium citrate had a better anticoagulant effect than LMWH for severe AKI patients treated by CRRT, improving renal function and filter longevity with fewer adverse effects.

摘要

简介

连续肾脏替代疗法(CRRT)在治疗急性肾损伤(AKI)方面是有效的,但需要使用抗凝剂。本研究旨在比较低分子肝素(LMWH)钠和柠檬酸钠对接受 CRRT 治疗的 AKI 患者的抗凝效果。

方法

回顾性分析 2020 年 1 月至 2023 年 1 月海南医学院第二附属医院(中国海南)收治的 150 例接受 CRRT 治疗的重度 AKI 患者的病历资料。对照组 72 例患者给予 LMWH 钠抗凝,观察组 78 例患者给予柠檬酸钠。比较两组患者治疗前后凝血指标、炎症因子和肾功能指标、滤器寿命和不良反应。

结果

与对照组相比,观察组治疗后凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)明显降低,血小板(PLT)明显升高(P<0.05),C 反应蛋白(CRP)和白细胞介素-6(IL-6)明显降低(P<0.05)。与对照组相比,观察组滤器使用寿命明显延长,总不良反应发生率明显降低(P<0.05)。

结论

柠檬酸钠在治疗 CRRT 的重度 AKI 患者时抗凝效果优于 LMWH,可改善肾功能,延长滤器寿命,且不良反应较少。

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