甲磺酸萘莫司他作为连续性肾脏替代治疗抗凝药物的临床应用

毅杰 蒋(新疆自治区人民医院，中国)
龙 蒋(新疆自治区人民医院，中国)
针 曹(新疆自治区人民医院，中国)
东 肖(新疆自治区人民医院，中国)

摘要

目前，连续性肾替代疗法（continuous renal replacement therapy，CRRT已成为危重患者最常见的重要器官支持形式。但CRRT也有其局限性，CRRT的主要缺点是需要持续抗凝以防止体外回路凝血。虽然在CRRT过程中需要抗凝来延长滤器的使用寿命，但大多数需要 CRRT 的患者都有出血的风险。对于有着高出血风险的患者，CRRT的体外抗凝是一项严峻的挑战。因此甲磺酸萘莫司他作为体外新型抗凝剂应运而生。甲磺酸萘莫司他(nafamostatmesylate，NM)半衰期短，体内代谢快、出血风险低，在日本及韩国已广泛使用，常用其作为有出血风险患者的CRRT体外抗凝剂，目前关于甲磺酸萘莫司他的临床数据多来自于日本及韩国，中国缺少甲磺酸萘莫司他作为连续性肾脏替代治疗的大量临床数据及临床应用经验。

关键词

连续性肾脏替代治疗；甲磺酸萘莫司他；体外抗凝

参考

Choi JY, Kang YJ, Jang HM, et al. Nafamostat mesilate as an anticoagulant during continuous renal replacement therapy in patients with high bleeding risk: A randomized clinical trial[J]. Medicine (Baltimore), 2015, 94(52):e2392.

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Miyatake Y, Makino S, Kubota K, et al. Association between intra-circuit activated clotting time and incidence of bleeding complications during continuous renal replacement therapy using nafamostat mesilate: a retrospective pilot observational study[J]. Kobe J Med Sci, 2017, 63(1):e30-e36.

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Nakamura Y, Tada K, Matsuta M, Murai A, Tsuchiya H. Anaphylactic Reactions Caused by Nafamostat Mesylate during Hemodialysis before Surgery for Carpal Tunnel Syndrome. Case Rep Nephrol. 2021 Dec 29;2021:1148156. doi: 10.1155/2021/1148156. PMID: 35003816; PMCID: PMC8731279.

DOI: http://dx.doi.org/10.12345/yzlcyxzz.v8i5.27071