Effect of citric acid anticoagulation on coagulation function and inflammatory factors in patients with sepsis with high-risk bleeding treated with continuous renal replacement therapy
10.3760/cma.j.cn115455-20240709-00583
- VernacularTitle:枸橼酸抗凝对脓毒症伴高危出血行连续性肾脏替代治疗患者凝血功能、炎性因子的影响分析
- Author:
Luheng GUO
1
;
Jing LI
;
Xuan ZHOU
;
Lin LIU
;
Zongke WANG
;
Bing YU
;
Rongqiang LIU
Author Information
1. 济宁医学院附属医院重症医学科，济宁 272100
- Publication Type:Journal Article
- Keywords:
Sepsis;
Hemorrhage;
Continuous renal replacement therapy;
Citric acid;
Electrolytes;
Inflammatory factors
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(12):1082-1086
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the effects of citric acid anticoagulation on coagulation function and inflammatory factors in patients with sepsis and high-risk bleeding treated with continuous renal replacement therapy (CRRT).Methods:A total of 80 patients with sepsis with high-risk bleeding who received CRRT treatment in the Affiliated Hospital of Jining Medical University from February 2018 to August 2023 were retrospectively selected as the study objects, 40 cases were treated with low molecular weight heparin (control group) and 40 cases were treated with citric acid (observation group).Both groups were treated continuously, and the anticoagulant effect, coagulation function, electrolyte and inflammatory factor levels of the two groups were compared 7 d after medication.Results:The total effective rate of anticoagulation in the observation group after treatment was higher than that in the control group: 97.50% (39/40) vs. 75.00% (30/40), there was statistical difference ( χ2 = 8.54, P<0.05). After treatment, the levels of activated partial thrombin time (APTT), thrombin time (TT) and prothrombin time (PT) in the observation group were lower than those in the control group: (31.08 ± 8.31) s vs. (41.76 ± 8.36) s, (23.41 ± 5.02) s vs. (29.05 ± 5.13) s, (15.47 ± 3.50) s vs. (19.96 ± 4.75) s, there were statistical differences ( P<0.05). There were no statistical differences in the levels of potassium, chloride, sodium and calcium between the two groups after treatment ( P>0.05). After treatment, the levels of C-reactive protein (CRP) and procalcitonin (PCT) in the observation group were lower than those in the control group :(2.60 ± 0.86) mg/L vs. (4.35 ± 1.12) mg/L, (0.11 ± 0.03) μg/L vs. (0.19 ± 0.05) μg/L, there were statistical differences ( P<0.05). Conclusions:The application of citric acid anticoagulant in patients with sepsis and high-risk bleeding treated with CRRT can achieve significant curative effect, which can not only improve the anticoagulant effect, stabilize coagulation function and electrolyte level, but also down-regulate the level of inflammatory factors.
