【摘要】 目的:探究局部枸橼酸抗凝对血液透析伴高危出血风险患者内皮舒张功能的影响。方法:选取我院2017年10月至2019年03月60例血液透析伴高危出血风险患者,采用数字随机法将患者分为对照组和观察组,每组各30例,对照组采用肝素抗凝,观察组采用局部枸橼酸抗凝,对比两组透析前后血管内皮舒张功能、血电解质、pH值、肾功能水平、凝血功能水平。结果:透析后观察组血管舒张功能(FMD)水平高于对照组(P<0.05),两组患者透析前后Na~+、K~+、Cl~-、总钙、pH值对比差异均不具有统计学意义(P>0.05),透析后观察组的血肌酐(Scr)、尿素氮(BUN)水平均高于对照组(P<0.05),透析后观察组(APTT)、活化凝血时间(ACT)水平均低于对照组(P<0.05)。结论:局部枸橼酸抗凝有助于保持患者血管内皮舒张功能的相对稳定,有效减小血液透析对于患者血管内皮功能的损伤。更多还原

【Abstract】 Objective: To investigate the effect of regional citrate anticoagulation on vascular endothelial dilation function(VEDF)in patients with high bleeding risk undergoing hemodialysis. Methods: 60 patients with high bleeding risk undergoing hemodialysis in the hospital from October 2017 to March 2019 were enrolled. They were divided into control group and observation group by random number table method, 30 cases in each group. The control group was given heparin anticoagulation, while observation group was given regional citrate anticoagulation. VEDF, blood electrolyte, pH value, renal function level and coagulation function levels before and after dialysis were compared between the two groups. Results: After dialysis, thelevel of FMD in observation group was higher than that in control group(P<0.05). Whereas there was no significant difference in Na+, K+, Cl-, total calcium levels or pH value before and after dialysis between the two groups(P>0.05). After dialysis, levels of Scr and BUN in observation group were higher than those in control group(P<0.05). Besides, the APTT and ACT levels in observation group were lower than those in control group after dialysis(P<0.05). Conclusion: Regional citrate anticoagulationhelps to maintain relative stability of VEDF in patients, and effectively reduces thevascular endothelial function damage caused by hemodialysis.更多还原