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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。
Objective To investigate the solute clearance effect of citrate anticoagulated hemodialysis solution in hemodialysis patients with hemorrhagic renal failure. Methods 42 patients with renal failure from 2002-06 to 2003-12 in the Second Hospital of Xi’an Jiaotong University were randomly divided into two groups: group Ⅰ hemodialysis with low molecular weight heparin anticoagulation dialysate, group Ⅱ with citrate anticoagulation dialysis fluid Dialysis. Blood urea nitrogen (BUN), creatinine (Cr) and activated and venous activated clotting time (ACT) and ionized calcium (iCa2 +) were measured before and after dialysis in both groups to calculate the urea removal index (Kt / V) URR). Results The venous end of ACT in group Ⅱ was significantly longer than the arterial end (P <0.01), while the iCa2 + in the venous end was significantly lower than that in the arterial end (P <0.01). The levels of BUN and Cr in blood of both groups were significantly lower than those before dialysis (P <0.01). The Kt / V and URR of dialysis in group Ⅱ were slightly higher than those in group Ⅰ, but the difference was insignificant (P0.05) . Conclusion Citrate anticoagulant hemodialysis solution has a good solute removal effect.