摘要
目的探讨枸橼酸抗凝(regional citrate anticoagulation,RCA)在维持性血液透析(maintenance hemodialysis,MHD)患者中的效果及对MHD患者血脂代谢的影响。方法将60例MHD患者随机分为RCA组(实验组)和普通肝素抗凝(unfraetionaled heparin,UFH)组(对照组),每组各30例。比较两组患者每次透析治疗后透析器整体纤维容积(total cellvolume,TCV)变化情况,患者在入组前、透析3个月、12个月血脂代谢的各项指标情况。结果⑴两组透析器使用后TCV变化情况比较,差异无统计学意义(P>0.05)。⑵对血脂的影响:①透析12个月后,两组总胆固醇(total cholesterol,TC)与透析前比较,差异无统计学意义(均P>0.05),对照组三酰甘油(three glycerine,TG)、脂蛋白(a)[(level of apolipoprotein(a),Lp(a)]、低密度脂蛋白(low density level of apolipoprotein,LDL-c)、极低密度脂蛋白胆固醇(very low density lipoprotein cholesterol,VLDL-c)均较透析前升高(均P<0.05),高密度脂蛋白胆固醇(high density level of apolipoprotein cholesterol,HDL-c)较透析前降低(P<0.05);实验组LP(a)较透析前升高、TG则比透析前降低(均P<0.05);②透析12个月两组比较,实验组TG、LDL-c、VLDL-c较对照组降低,组间比较,差异具有统计学意义(均P<0.05)。结论 RCA体外抗凝效果确切,透析器使用后TCV不受影响,透析效果好,且不良反应少;应用RCA体外抗凝不加重MHD患者血脂代谢紊乱。
Objective To investigate the effect of regional citrate anticoagulation（RCA） in hemodialysis and influence on lipid of hemodialysis patients（HD）.Methods Sixty HD patients were divided into the experiment and the control group.In the experiment group RCA were used while unfractionated heparin were used in the control group.The dialyzer＇s total cell volume（TCV） after dialysis and patients＇ lipid metabolism before treatment,3 months and 12 months after treatment were compared between the two groups.Results（1） Coagulation in the vein pot was slightly more in the experiment group than that in the control group.There wasn＇t significant deference in TCV after hemodialysis between 2 groups（P 0.05）.（2） The influence on lipid：①12 months after dialysis treatment：the levels of total cholesterol（TC） in the control group wasn＇t changed while three glycerine（TG）,level of apolipoprotein（a）（Lp（a））,low density level of apolipoprotein（LDL-c）,low density level of apolipoprotein cholesterol（VLDL-c） were increased and high density level of apolipoprotein cholesterol（HDL-c） was lower than before（P 0.05）.In the experiment group,the levels of Lp（a） was increased and TG was lower（P 0.05）.②12 months after dialysis treatment,the levels of TG,LDL,VLDL were lower in the experiment group than that in the control group,and the difference was significant（P 0.05）.Conclusions The anticoagulation effect of RCA was exact and there was no effect on TCV.The use of RCA during dialysis does not aggravate the disorders of lipid metabolism.
出处
《现代临床护理》
2011年第2期15-17,20,共4页
Modern Clinical Nursing
基金
广西科学基金资助
项目编号为桂科0679016
关键词
枸橼酸
肝素钠
抗凝
血液透析
血脂
regional citrate
unfractionated heparin
anticoagulation
hemodialysis
lipid metabolism
作者简介
陈荣姣（1964-），女，广西平乐人，主管护师，大专，主要从事血液净化护理工作。
[通讯作者]李康慧，主治医师，本科，Email：likanghui5819818@163．com。
