Objective To explore the anticoagulant effect and safety of different dosages of nafamostat mesylate for patients taking hemodialysis.Methods According to the dosages of nafamostat mesylate,the patients were divided into a 10 mg/h nafamostat mesilate group(33 cases),including 23 males and 10 females who were(58.8±16.0)years old,and a 20 mg/h nafamostat mesilate group(32 cases),including 17 males and 15 females who were(62.6±15.7)years old.All the patients took hemodialysis for 4 h per time,3 times per week.The data were compared between the two groups by independent-sample t test or non-parameter test.The rates of venous clotting,artery clotting,and cumulative catheter blockage were compared between the two groups by Kaplan-Meier survival analysis and log-rank test.Results A total of 65 patients undergoing maintenance dialysis were included;they underwent 178 case times of nafamostat mesilate anticoagulation,including 87 case times in the 10 mg/h nafamostat mesilate group and 91 case times in the 20 mg/h nafamostat mesilate group.There were no statistical differences in gender,age,body weight,height,coronary heart disease,diabetes mellitus,bleeding causes,and laboratory indicators between the two groups(P＞0.05).More patients had venous clotting score of 3 in the 10 mg/h nafamostat mesilate group than in the 20 mg/h nafamostat mesilate group[6.9％(6/87)vs.3.3％(3/91)],with a statistical difference(P＜0.05).The treatment time in the 20 mg/h nafamostat mesilate group was longer than that in the 10 mg/h nafamostat mesilate group[(225.0±21.3)min vs.(217.0±18.1)min],with a statistical difference(t=-2.587;P＜0.05).The pre-dialysis transmembrane pressure and arterial pressure in the 20 mg/h nafamostat mesilate group were significantly lower than those in the 10 mg/h nafamostat mesilate group[(57.0±43.4)mmHg(1 mmHg=0.133 kPa)vs.(77.3±31.2)mmHg and(-82.3±28.9)mmHg vs.(-71.1±29.4)mmHg],with statistical differences(t=3.488 and 2.448;both P＜0.05).The survival analysis showed that there was no statistical difference in the catheter blockage rate between the two groups(P＞0.05).After anticoagulation with nafamostat mesilate,2 cases(3.1％)experienced aggravated bleeding in the 65 patients.Conclusion Anticoagulation with nafamostat mesilate in standard hemodialysis treatment has a low incidence of venous clotting occlusion and minor bleeding risk.The 20 mg/h dosage of nafamostat mesilate exhibits better effectiveness,can reduce the rate of venous clotting and offer a new anticoagulation method for patients taking maintenance dialysis at high risk of bleeding.
维普
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