不同的抗凝方法用于连续替代疗法在患有高乳糖血症和高出血风险的患者
Chunyan Song1,2, Rong Li1,2, Siwei Tang1,2
1Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
The International journal of artificial organs
|August 16, 2025
概括
对于高风险患者的连续置换疗法 (CRRT),纳法莫斯塔特甲基酸盐 (NM) 或区域酸盐抗凝药 (RCA) 可能比不使用抗凝药提供更好的过寿命和减少出血. 仔细监测对于安全有效的使用至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 密集护理医学 密集护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 在患有高乳糖血症和出血风险的患者中,CRRT的最佳抗凝剂尚不清楚.
- 现有策略缺乏共识,需要对安全性和有效性进行评估.
研究的目的:
- 评估CRRT不同抗凝方法的安全性和有效性,用于患有高乳糖血症和高出血风险的患者.
主要方法:
- 对接受CRRT而没有抗凝药 (NA),纳法莫斯塔特甲基酸盐 (NM) 或区域酸盐抗凝药 (RCA) 的患者进行回顾性研究.
- 收集的数据包括过器寿命,出血并发症,输血和不良反应.
- 患者患有高乳糖血症 (>=2 mmol/L) 和高出血风险.
主要成果:
- 纳法莫斯甲基 (NM) -CRRT (41小时) 和区域酸盐抗凝剂 (RCA) -CRRT (36小时) 的过器寿命明显长于没有抗凝剂 (NA) -CRRT (25小时) (p<0.001).
- 亚洲组的出血并发症 (43.4%) 和输血 (28.3%) (p=0.003,p=0.047) 的发生率显著更高.
- 在NA组中,30天死亡率明显高于NA组 (p=0.037).
结论:
- 纳法莫斯甲基酸盐 (NM) 和区域酸盐抗凝剂 (RCA) 显示出在CRRT中延长波器寿命的潜力.
- 这些抗凝血策略可以降低患有高乳糖血症和高出血风险的患者的出血风险.
- 在这种患者群体中,通过仔细监测和及时调整,NM和RCA似乎对CRRT安全有效.
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