【摘要】 目的　研究枸橼酸盐抗凝血液透析液在高危出血肾衰患者血液透析中的溶质清除效果。方法　西安交通大学第二医院2002-06~2003-12的42例肾衰患者随机分成两组:Ⅰ组行低分子肝素抗凝透析液血液透析,Ⅱ组行枸橼酸盐抗凝透析液血液透析。检测两组透析前后血尿素氮(BUN)、肌酐(Cr)及Ⅱ组动、静脉端活化凝血时间(ACT)和离子钙(iCa2+ ),计算尿素清除指数(Kt/V)及尿素下降率(URR)。结果　Ⅱ组静脉端ACT较动脉端显著延长(P<0 .01),静脉端iCa2+较动脉端显著降低(P<0 .01)。两组透析后血BUN、Cr均比透析前明显降低(P<0. 01),Ⅱ组透析的Kt/V及URR均略高于Ⅰ组,但差异无显著性(P>0. 05)。结论　枸橼酸盐抗凝血液透析液的溶质清除效果良好。更多还原

【Abstract】 Objective To study the solute clearance effect of t he new concentrated anticoagulation hemodialysate of citrate for hemodialysis in patients with high risk of bleeding.Methods During the period of 2002-06~2003-12,42 patients with h igh risk of bleeding were divided into two groups according to hemodialysis mann ers.Group Ⅱ were hemodialyzed with new citrate anticoagulation hemodialysate wi thout any other anticoagulant and group Ⅰ were hemodialyzed with bicarbonate he modialysate with dalteparin anticoagulation.The BUN and Cr levels were determine d before and after dialysis and Kt/V and URR were calculated.In addition,ACT and iCa 2+ were also measured at the artery and venous end.Results ACT was extended and iCa 2+ decreased significantl y at the venous end compared with that at the artery end in group Ⅱ (P<0.01 ).The BUN and Cr levels were markedly decreased after dialysis compared with tha t before dialysis in two groups (P<0.01),and no significant difference in so lute clearance effect,as indicated by Kt/V and URR,was observed between group Ⅰ and group Ⅱ (P>0.05).Conclusion The solute clearance effect of the new concentrated anticoagulation hemodialysate of citrate for hemodialysis in patients with high risk of bleeding is excellent.更多还原