摘要
目的研究阿加曲班在危重症患者连续性血液净化治疗中的临床疗效。方法将笔者医院收治的150例危重症患者随机分为普通肝素组(48例)、枸橼酸钠组(50例)和阿加曲班组(52例)。检测各组治疗前后血常规、生化指标、血流动力学指标、血凝指标及凝血程度情况,进一步观察不良反应发生情况。结果各组患者治疗后血红蛋白、血小板计数及白蛋白水平差异无统计学意义(P>0.05),但阿加曲班组血清肌酐水平较普通肝素组和枸橼酸钠组降低更明显(P<0.05)。与普通肝素组和枸橼酸钠组比较,阿加曲班组治疗后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及国际标准化比值(INR)显著升高,纤维蛋白原(FBG)则显著降低(P<0.05);同时阿加曲班组滤器及管路凝血程度明显降低即0级凝血明显增多,Ⅰ级和Ⅱ级凝血明显减少(P<0.05);3组出血评分比较,差异无统计学意义(P>0.05)。结论阿加曲班在危重症患者血液净化治疗过程中显示出显著的临床效果,值得临床进一步应用推广。
Objective To study the clinical efficacy of argatroban in critically patients with continuous blood purification treatment. Methods A total of 150 cases critically patients in our hospital were randomly divided into common heparin group （48 cases）, sodium citrate group （50 cases）, argatroban group （52 cases）. The routine blood test, biochemical indicators, hemodynamics, blood coagulation index level before and after treatment were measured, and the adverse effect were further observed. Results The hemoglobin, platelet count and albumin levels after treatment in each group had no significantly difference （P〉0.05）, but the serum creatinine levels in argatroban group were reduced more than the common heparin group and sodium citrate group （P〈0.05）. Compared with the common heparin group and sodium citrate group, the PT,APTT,TT and INR after treatment in argatroban group was significantly higher, but FBG was lower （P〈0.05）. Meanwhile, the blood coagulation extent of filters and pipes including 0 grade was increased,Ⅰgrade and Ⅱ grade were decreased （P〈0.05）. The difference in bleeding scores among the three groups was not statistically significant （P〉0.05）. Conclusion The argatroban shows a significant clinical efficacy in critically patients with continuous blood purification treatment, which is worthy of further clinical use and promotion.
出处
《医学研究杂志》
2016年第3期97-101,共5页
Journal of Medical Research
基金
重庆市卫生与计划生育委员会医学科研计划项目(20143062)
关键词
阿加曲班
血液净化
普通肝素
枸橼酸钠
Argatroban
Blood purification
Common heparin
Sodium citrate
