局部枸橼酸抗凝与全身肝素抗凝在ARDS并发AKI患者CRRT治疗中的效果比较

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Abstract Objective To compare the efficacy of local citrate anticoagulation and systemic heparin anticoagulation on continuous renal replacement therapy (CRRT) in acute respiratory distress syndrome (ARDS) patients with acute kidney injury (AKI). Methods A total of 36 patients with ARDS complicated with AKI who underwent CRRT between March 2017 and September 2018 in the Department of Intensive Medicine of Suzhou Municipal Hospital were divided into heparin group (18 cases) and citrate group (18 cases) by random number table method. The renal function (serum creatinine [Cr], blood urea nitrogen [BUN]), blood coagulation-related indexes (activated partial thromboplastin time [APTT], prothrombin time [PT], platelet count), filter useful life and occurrence of adverse reactions were compared before and after treatment between the two groups. Results There were no significant differences in the renal function and blood coagulation-related indexes before and after treatment between the two groups (all P ＞ 0.05). After treatment, BUN and Cr levels, platelet accounts after treatment in the two groups were lower than before treatment, while PT and APTT were longer than before treatment, the differences were statistically significant (all P ＜ 0.05). After treatment, the platelet account of heparin group was lower than that of the citrate group, and PT and APTT were longer than the citrate group, the differences were statistically significant (all P ＜ 0.05). The filter useful life of heparin group was shorter than that of the citrate group, the difference was statistically significant (P ＜ 0.05). There were no adverse events during the treatment in both groups. Conclusion In the CRRT treatment of ARDS complicated with AKI, the local application of citrate has better anticoagulant effect, which can prolong the life of the filter and is safer.

Key words： Heparin anticoagulation Citrate anticoagulation Acute respiratory distress syndrome Acute kidney injury Continuous renal replacement therapy

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	LU Wei1 YAN Xianliang2 LIU Li3 LU Haiyan3 ZHANG Gaofeng3 ZHANG Xiaonan3

Cite this article:

LU Wei1 YAN Xianliang2 LIU Li3 LU Haiyan3 ZHANG Gaofeng3 ZHANG Xiaonan3. Comparison of the effect of local citrate anticoagulation and systemic heparin anticoagulation on CRRT in ARDS patients with AKI[J]. 中国医药导报, 2020, 17(32): 152-155.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I32/152

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