The Comparison Of Anticoagulant Effect Of Argatroban And Heparin In Continuous Blood Purification

Objective:To compare the anticoagulant efficacy and safety of Argatorban and Unfractionated heparin in the treatment of critically ill patients with continuous blood purification(CBP),optimize the anticoagulant mode of continuous blood purification in the therapy of critically ill patients.Method:Forty patients with CBP in our hospital(Binhai Hospital of Tianjin Medical University General Hospital)were randomly divided into experimental group(n = 10)and control group(n = 30),The experimental group was treated with Argatorban anticoagulation,while the control group was treated with Unfractionated heparin(UFH)anticoagulation.Incontinuous blood purification(CBP)treatment,monitoring activated partial thromboplastin time(APTT)of patients before treatment,treated for 3 hours,before treatment and after treatment.Monitoring Platelet count before and after treatment in patients with CBP,Observe the blood coagulation situation of pipeline and filter,Observe the situation of bleeding in patients.Monitoring Platelet count of patients before CBP treatment and after continuous CBP treatment.Results:There was a statistical difference in APTT prolongation time between 3 hours after CBP treatment and at the end of treatment in the group of Argatorban and Unfractionated heparin(P<0.05).The APTT returned to normal 1 hour after the end of the Argatorban treatment group(P>0.05),The UFH group was still higher than before treatment(P<0.05),There was statistical difference between the two groups(P<0.05).There was no statistical difference in the pipeline and filter blood coagulation score between Argatorban group and Unfractionated heparin group(P>0.05).There was no statistical difference in Bleeding score after blood purification treatment between Argatorban group and Unfractionated heparin group(P>0.05).There was no statistical difference in Platelet count before blood purification treatment between Argatorban group and Unfractionated heparin group(P>0.05),Continuous CBP treatment after 5days,The heparin group platelet count was significantly lower than that of argatroban group(P<0.05),Heparin group was significantly lower than before treatment(P<0.05).Conclusion:1.Comparison of anticoagulant effects between Argatorban and Unfractionated heparin,there was no significant difference in the coagulation score of the pipeline and filter.2.Comparison of anticoagulant effects between Argatorban and Unfractionated heparin,there was no significant difference in the bleeding score of the puncture tube.3.The study found that the Unfractionated heparin group can play the role of full anticoagulation,But in the 1 hours after the end of dialysis activated partial thromboplastin time still higher than before dialysis,significant compared with before dialysis.In addition,the platelet decline after dialysis is more obvious,compared with before treatment is significant,it increased the risk of subsequent bleeding.4.The study found that the Argatorban group can play the role of full anticoagulation also,in the 1 hours after the end of dialysis activated partial thromboplastin time can recover to the level before dialysis,there was no difference compared with that before dialysis.In addition,the platelet count decline after dialysis was not obvious,there is no difference compared with that before treatment,reduce the occurrence of subsequent bleeding events.Argatroban anticoagulation therapy has small effects on the activated partial thromboplastin time and platelet count.