CN116052837B - Method for evaluating dosage of anticoagulant in hemodialysis - Google Patents
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1601—Control or regulation
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/40—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/50—General characteristics of the apparatus with microprocessors or computers
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Abstract
The invention discloses an evaluation method of anticoagulant dosage in hemodialysis, which comprises the following steps: step 1) determining a parameter related to body surface area of a subject; step 2) calculating the body surface area of the subject by using the parameters obtained in the step 1); step 3) determining the anti-factor Xa activity of the subject 0.5 hours after administration of the anticoagulant; step 4) deducing a relation formula between the dosage of the anticoagulant and the activity of resisting Xa factor and the body surface area by using a multiple linear regression method, and evaluating the optimal dosage of the anticoagulant by using the formula; wherein the anticoagulant is low molecular weight heparin. The optimal dosage calculation formula of the anticoagulant in the hemodialysis can provide an individual accurate anticoagulation scheme, better improve the hemodialysis effect, reduce the problems of coagulation and blood loss in the dialysis process of patients, and reduce complications such as bleeding, embolism and the like and various complications, thereby improving the life quality of hemodialysis patients to the maximum extent.
Description
Technical Field
The invention relates to the biomedical field, in particular to an evaluation method of anticoagulant dosage in hemodialysis.
Background
The significant increase in the incidence of chronic kidney disease (CKD, chronic renal disease) has become a worldwide medical and public health problem, with poor prognosis, longer years, and high costs, which is one of the diseases that seriously jeopardize human health worldwide, and an important alternative to survival is hemodialysis. Patients who maintain dialysis worldwide increase at a rate of 7% per year, greater than the world population growth rate. Currently, hemodialysis patients registered in China are about 70 ten thousand.
Inadequate dialysis exacerbates complications such as anemia, cardiovascular disease, malnutrition, and increased mortality in patients. Throughout hemodialysis, contact is ubiquitous (between circulating blood and extracorporeal circulation tubing). For the high risk factor of thrombosis of patients, the extracorporeal circulation pipeline and the components thereof are the culprit, and the normal physiological hemostatic balance of the patients is converted into a hypercoagulable state. In order to inhibit activation of the coagulation mechanism and prevent thrombosis, infusion of anticoagulants is necessary for treatment. Whether anticoagulation is sufficient is a key factor affecting dialysis quality. Insufficient anticoagulation often results in clotting of the tubing leading to insufficient dialysis or massive blood loss due to inability to return blood; excessive anticoagulation increases the risk of bleeding in patients, and increases cardiovascular and cerebrovascular events and mortality. Therefore, by adopting an individual accurate anticoagulation scheme, the hemodialysis effect can be better improved, the life quality of patients is improved, and the method has positive therapeutic significance. Unfortunately, clinical practice guidelines (for hemodialysis anticoagulant therapy) are not standardized and reports of clinical actual conditions are rare.
Hemodialysis often selects either plain heparin (unfractionated heparin, UFH) or low molecular heparin (low molecular weight heparin, LMWH) for anticoagulant therapy, but there is no positive conclusion on how to select, adjust the dosage, and whether to apply the clinical guidelines and clinical practices. Conventionally, UFH uses monitoring APTT as a basis for adjusting UFH, but recently, it has been found that APTT is susceptible to multiple factors, and monitoring with anti-Xa activity (anti-Xa) can shorten the time for heparin to reach an anti-thrombus therapeutic range, and is stable and not susceptible to various external or disease conditions, so that monitoring with anti-Xa is more recommended. LMWH is an indirect inhibitor of factor x. For factor Xa, therefore, anti-Xa is used clinically for LMWH dose monitoring; APTT is nonreactive to LMWH. Compared with the traditional blood coagulation function detection (PT, APTT, TT and fbg), the Thromboelastography (TEG) can comprehensively reflect the functions of platelet blood coagulation factors and fibrinolytic systems, wherein the rapid TEG (rTEG) can timely and accurately adjust the dosage of heparin medicines, and is significant in evaluating the blood coagulation state of hemodialysis patients and accurately grasping the anticoagulant dosage. However, rTEG is mainly used for guiding blood transfusion during surgery, monitoring and correcting hypercoagulability, evaluating curative effects and resisting progress of antiplatelet drugs (aspirin, clopidogrel, etc.), and no study on guiding anticoagulation effect of hemodialysis is performed. Therefore, it is urgent to find a method capable of rapidly and accurately guiding the dosage of the anticoagulant in hemodialysis, which can standardize the use of the anticoagulant in hemodialysis and provide important evidence for smooth progress of the dialysis process and prevention of serious complications such as bleeding, embolism and the like.
Disclosure of Invention
In one aspect, the invention provides a novel method for evaluating the dosage of an anticoagulant in hemodialysis, which aims at the condition that the standardized rapid and accurate method for evaluating the dosage of the anticoagulant is lack in the hemodialysis process in the prior art.
The technical scheme provided by the invention is as follows:
a method for assessing the amount of anticoagulant used in hemodialysis comprising the steps of:
step 1) determining a parameter related to body surface area of a subject;
step 2) calculating the body surface area of the subject by using the parameters obtained in the step 1);
step 3) determining the anti-factor Xa activity of the subject 0.5 hours after administration of the anticoagulant;
step 4) deducing a relation formula between the dosage of the anticoagulant and the activity of resisting Xa factor and the body surface area by using a multiple linear regression method, and evaluating the optimal dosage of the anticoagulant by using the formula;
wherein the anticoagulant is low molecular weight heparin.
In the present invention, the inventors found that the activity of anti-Xa factor of 0.5h after the start of hemodialysis could reach a peak rapidly and the activity of anti-Xa factor was moderately-highly correlated with the LMWH/body surface area ratio, wherein the correlation of the activity of anti-Xa factor of 0.5h with the LMWH/body surface area was the highest, and the R value was: 0.739 (P < 0.001). Based on the findings described above, the optimal amount of anticoagulant for hemodialysis can be derived using a multiple linear regression method.
Preferably, in one embodiment of the present invention, the relational formula described in step 4) is: anticoagulant dose = (0.156 x anti-factor Xa activity of subjects +0.1) x body surface area at 0.5 hours after administration of the anticoagulant.
Further preferably, the parameters related to body surface area are the height and weight of the subject. The height is m 2 The weight is Kg.
In the present invention, the body surface area may be calculated using a suitable method in the prior art. Preferably, in one embodiment of the present invention, the Stevenson formula is used to calculate: body surface area (m 2) =0.0061×height (cm) +0.0128×weight (kg) -0.1529.
In the present invention, the anti-factor Xa activity can be determined using methods appropriate in the art. In one embodiment of the invention, the anti-factor Xa activity is detected using a clotting method, a luminescent substrate method, or an immunological method.
In another aspect of the invention, a system for assessing the amount of anticoagulant used in hemodialysis is provided, which implements the above method by inputting a parameter of a subject to obtain an optimal amount of the anticoagulant.
In another aspect of the invention, there is provided a device for assessing the amount of anticoagulant used in hemodialysis, said device comprising: a memory, a processor, and a computer program stored on the memory and executable on the processor; the computer program, when executed by the processor, performs a method as claimed in any one of claims 1 to 5.
In another aspect of the present invention, a computer readable storage medium having the system described above stored thereon is provided.
The beneficial effects of the invention are as follows:
the optimal dosage calculation formula of the anticoagulant in the hemodialysis, which is obtained by the method, can provide an individual accurate anticoagulation scheme, better improve the hemodialysis effect, reduce the problems of coagulation and blood loss in the dialysis process of patients, reduce complications such as bleeding and embolism and various complications, and further improve the life quality of hemodialysis patients to the maximum extent.
Drawings
FIG. 1 is a flowchart of a research method in an embodiment of the invention;
FIG. 2 is a graph showing the trend of changes in anti-factor Xa activity in MHD patients in the examples of the present invention.
Detailed Description
The invention discloses a method for evaluating the dosage of an anticoagulant in hemodialysis, and a person skilled in the art can properly improve the technological parameters by referring to the content of the invention. It is to be particularly pointed out that all similar substitutes and modifications apparent to those skilled in the art are deemed to be included in the invention and that the relevant person can make modifications and appropriate alterations and combinations of what is described herein to make and use the technology without departing from the spirit and scope of the invention.
In the present invention, unless otherwise indicated, scientific and technical terms used herein have the meanings commonly understood by one of ordinary skill in the art. Throughout the specification and claims, unless explicitly stated otherwise, the term "comprise" or variations thereof such as "comprises" or "comprising", etc. will be understood to include the stated element or component without excluding other elements or components. The terms "such as," "for example," and the like are intended to refer to exemplary embodiments and are not intended to limit the scope of the present disclosure.
In order to enable those skilled in the art to better understand the technical solution of the present invention, the present invention will be further described in detail with reference to specific embodiments.
Example 1: establishment of hemodialysis anticoagulation formula
The flow of the research method is shown in figure 1.
Inclusion criteria: maintenance hemodialysis patient with age not less than 18 years old
Exclusion criteria: heparin anticoagulant is unsuitable for acute hemorrhage; additional anticoagulants are required for thromboembolic events; liver failure and other researchers consider it unsuitable for situations where this study is entered.
According to the clinical practical use condition of the anticoagulants of the subjects, the subjects are divided into 2 groups: UFH group and LMWH group. Recording the gender, age, underlying kidney disease, complications, diet, weight, height of all subjects; blood routine (hemoglobin, platelet count), clotting assay (PT, APTT, TT, FIB, DD, PTA), biochemistry (creatinine, urea ammonia, albumin, total cholesterol, triglycerides, low density lipoproteins, high density lipoproteins) within 4 weeks prior to study entry.
Study day, blood withdrawal was monitored for anti-Xa, AT III and rTEG 0.5h, 1h, 2h, 3h, 4h after the hemodialysis session and AT the session, and dialyzer coagulation grade was recorded AT the session (see Table 1). Beckman Coulter fully automatic coagulation analyzer ACL TOP500CTS anti-factor Xa activity was detected using clotting method (671 nm), luminescent substrate method (405 nm), immunological method (405 nm or 671 nm).
TABLE 1 Filter and blood vessel coagulation fractionation
The preparation is repeated for 2-3 times until reaching stable anticoagulation prescription.
Within 4 weeks from the start of the study, no change was made to the anticoagulation regimen of the subjects, and the presence or absence of bleeding, thromboembolic events were recorded.
Data analysis:
a total of 46 patients were enrolled in groups of 34 men (75%). This study recorded 5 ECC events. The single intravenous injection of LMWH before the start of hemodialysis, the anti-Xa factor activity after 0.5h after the start of hemodialysis reaches the peak value rapidly, which is 0.789+ -0.260 (IU/mL), the anti-Xa factor activity gradually decreases with the progress of hemodialysis, the anti-Xa factor activity after 4h is the lowest, which is 0.349+ -0.183 (IU/mL), and the result is shown in FIG. 2.
Correlation was calculated using SPSS: the correlation analysis of the anti-Xa factor activity and the LMWH dose/body weight ratio and the LMWH dose/body surface area ratio shows that: factor Xa resistance activity was moderately correlated with the LMWH dose/body weight ratio. Factor Xa resistance is moderately-highly correlated with the LMWH/body surface area ratio, where 0.5h factor Xa resistance has the highest correlation with LMWH/body surface area, and R is: 0.739 (P < 0.001). See table 2. Whereas it has been demonstrated above that LMWH reaches the peak anticoagulant effect 0.5h after intravenous injection; from the relationship between factor Xa resistance and the amount of LMWH for 0.5h, we used a linear regression method to derive the estimation formula: y= (0.156x+0.1) ×body surface area [ x=0.5 h anti-factor Xa activity (IU/mL), y=low molecular weight heparin dose (mL) ], whereby the LMWH dose required to achieve the target anti-factor Xa activity is estimated.
TABLE 2 significance Table of Anti-Xa vs. LMWH dose
Experimental example 1: feasibility verification
Verification was performed in another dialysis patient database according to the formula derived in example 1 for a total of 110 dialysis patients. According to literature reports, the factor Xa activity for 0.5h is ideally 0.8-1.0IU/mL, we set x=0.8, and a prediction (Y) of LMWH dose is made for all patients, comparing the resulting Y with the actual LMWH (Y'): comparison value z= (1-Y/Y')x100%. Absolute values of Z are considered to be within 20% acceptable, predictively accurate. The results show that: of 92 patients with no clotting event in the lower machine, 85 (92.39%) were predicted accurately; of the 18 patients who had undergone coagulation, Y was significantly greater than Y' and Z was all over 20% absolute. We therefore consider this formula to be validated as viable.
The foregoing is merely a preferred embodiment of the present invention and it should be noted that modifications and adaptations to those skilled in the art may be made without departing from the principles of the present invention, which are intended to be comprehended within the scope of the present invention.
Claims (8)
1. A method for assessing the amount of anticoagulant used in hemodialysis comprising the steps of:
step 1) determining a parameter related to body surface area of a subject;
step 2) calculating the body surface area of the subject by using the parameters obtained in the step 1);
step 3) determining the anti-factor Xa activity of the subject 0.5 hours after administration of the anticoagulant;
step 4) deducing a relation formula between the dosage of the anticoagulant and the activity of resisting Xa factor and the body surface area by using a multiple linear regression method, and evaluating the optimal dosage of the anticoagulant by using the formula;
wherein the anticoagulant is low molecular weight heparin.
2. The method of claim 1, wherein the relationship formula in step 4) is: anticoagulant dose = (0.156 x anti-factor Xa activity of subjects +0.1) x body surface area at 0.5 hours after administration of the anticoagulant.
3. The assessment method according to claim 1 or 2, wherein the parameters related to body surface area are the height and weight of the subject.
4. The method of evaluating according to claim 3, wherein the method of calculating the body surface area is: body surface area m 2 =0.0061×height cm+0.0128×weight Kg-0.1529.
5. The assessment method according to claim 1 or 2, characterized in that the anti-factor Xa activity is detected by coagulation, luminescent background or immunological methods.
6. A system for assessing the amount of anticoagulant in hemodialysis, wherein the system implements the method of any one of claims 1-5, and wherein the optimal amount of anticoagulant is obtained by inputting a parameter of a subject.
7. A device for assessing the amount of anticoagulant used in hemodialysis, said device comprising: a memory, a processor, and a computer program stored on the memory and executable on the processor;
the computer program, when executed by the processor, performs a method as claimed in any one of claims 1 to 5.
8. A computer readable storage medium having stored thereon the system of claim 6.
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Non-Patent Citations (6)
| Title |
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| 刘美明,吴树明,张希全.心脏瓣膜置换术后早期抗凝剂量相关因素分析及临床意义.实用医学杂志.2005,(03),全文. * |
| 徐丹 ; 刘媛 ; 钟诗龙 ; 杨敏 ; 林曙光 ; 余细勇 ; 劳海燕 ; .心脏瓣膜置换术后影响华法林抗凝疗效的人口学因素分析.实用医学杂志.2010,(05),全文. * |
| 心脏瓣膜置换术后影响华法林抗凝疗效的人口学因素分析;徐丹;刘媛;钟诗龙;杨敏;林曙光;余细勇;劳海燕;;实用医学杂志(05);全文 * |
| 心脏瓣膜置换术后早期抗凝剂量相关因素分析及临床意义;刘美明,吴树明,张希全;实用医学杂志(03);全文 * |
| 王康 ; 吴胜楠 ; 李德萍 ; .血液透析体外循环中依诺肝素的抗凝剂量控制.广东医学.2010,(05),全文. * |
| 血液透析体外循环中依诺肝素的抗凝剂量控制;王康;吴胜楠;李德萍;;广东医学(05);全文 * |
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