Abstract：Objective To compare the anticoagulant effect and safety of argatroban and sodium citrate in continuous renal replacement therapy (CRRT). Methods A total of 132 patients treated between September 2018 and May 2019 were randomly divided into the argatroban group (n=60) and sodium citrate group (n=72). The two groups were treated with argatroban and sodium citrate as the anticoagulant therapy respectively. The general condition, activated clotting time (ACT),serum calcium, hemoglobin (Hb),platelet count (PLT) and urea reduction rate (URR) were recorded and compared between the two groups. The blood coagulation of filters and pipes during treatment and bleeding events 24 h after treatment were also observed and compared. Results There was no significant difference in general data between the two groups.The ACT was within the normal range before treatment in both groups. In the argatroban group,the ACT was significantly increased 5 min, 2 h and 4 h into the treatment (P<0.05), but significantly reduced to the normal range after 1 hour of treatment. In the sodium citrate group, there was no significant change in the ACT during or after treatment. There was also no significant change in levels of serum calcium before, during and after dialysis in the sodium citrate group.The levels of serum calcium in vitro during dialysis were lower than those in vivo at the same time (P<0.05). There was no significant change in Hb or PLT before and after treatment, and the serum creatinine level was significantly decreased in the two groups (P<0.05). There was no statistically significant difference in the duration of treatment, URR value, coagulation in the pipeline filters and bleeding events between the two groups. Conclusions Argatroban and sodium citrate are effective and safe anticoagulants in the treatment of CRRT. For patients at high risk of bleeding, sodium citrate may be a better choice.
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ZHANG Xin, ZHANG Wenbo, LI Ying, LI Hao, LIU Yuanyuan, HUO Yanhong. Comparison of efficacy and safety of argatroban and sodium citrate in continuous blood purification therapy. Med. J. Chin. Peop. Armed Poli. Forc., 2020, 31(2): 103-106.
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