甲磺酸萘莫司他在血液透析患者中的抗凝效果与安全性评价

陈晨

doi:10.2095-3593.2026.060003

中国药物评价 >

2026 , Vol. 43 >Issue 3: 226 - 226-230

DOI: https://doi.org/10.2095-3593.2026.060003

临床研究

甲磺酸萘莫司他在血液透析患者中的抗凝效果与安全性评价

陈晨

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启东市人民医院，启东肝癌防治研究所，南通大学附属启东医院，江苏南通 226200

陈晨，女，副主任中医师，研究方向：肾小球疾病及血液透析

收稿日期: 2026-01-07

修回日期: 2026-03-11

录用日期: 2026-08-05

网络出版日期: 2026-08-12

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Evaluation of the Anticoagulant Efficacy and Safety of Nafamostat Mesylate in Hemodialysis Patients

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Qidong Hospital， Affiliated to Nantong University， Jiangsu Nantong 226200， China

Received date: 2026-01-07

Revised date: 2026-03-11

Accepted date: 2026-08-05

Online published: 2026-08-12

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摘要

目的：探讨甲磺酸萘莫司他（nafamostat mesylate，NM）在血液透析患者体内的抗凝作用与安全性状况。方法：2023年1月至2024年8月我院接受血液透析的100例患者被随机分为观察组（NM）和对照组（标准抗凝剂肝素），每组各50例。分别对两组患者的抗凝效果、凝血功能、酸碱平衡及电解质水平进行比较。结果：观察组的抗凝总有效率为90.0%，高于对照组的60.0%（P<0.001）。观察组透析器和管路内纤维蛋白沉积较少，凝血功能更为稳定（P>0.05）。透析后2、4 h，观察组患者体内APTT明显延长（P<0.05）。观察组透析后4 h凝血功能均优于对照组（P<0.05）。透析前后pH、Na+、K+等酸碱平衡和电解质水平以及出血并发症在两组间差异无统计学意义（P>0.05）。结论：NM在血液透析中的抗凝效果优于传统抗凝剂，且安全性高。NM能够有效预防透析过程中纤维蛋白沉积，保持透析器的通透性，减少出血风险。

关键词： ; font-size:medium; ">血液透析；甲磺酸萘莫司他；抗凝效果；安全性；凝血功能

本文引用格式

陈晨 . 甲磺酸萘莫司他在血液透析患者中的抗凝效果与安全性评价[J]. 中国药物评价, 2026 , 43(3) : 226 -226-230 . DOI: 10.2095-3593.2026.060003

Abstract

Objective： To evaluate the anticoagulant efficacy and safety of nafamostat mesylate (NM) in patients undergoing hemodialysis. Methods： A total of 100 patients undergoing hemodialysis in our hospital between January 2023 and August 2024 were randomly assigned to either the observation group (NM) or the control group (standard anticoagulant heparin)， with 50 patients in each group. The anticoagulant efficacy， coagulation function， acid-base balance， and plasma electrolyte levels were compared between the two groups. Results： The total effective rate of anticoagulation in the observation group was 90.0%， higher than that of the control group（60.0%） (P<0.001). The observation group showed less fibrin deposition in the dialyzer and tubing， and more stable coagulation function (P>0.05). The APTT in vivo of the observation group was significantly prolonged at 2， 4 h after dialysis (P<0.05). The coagulation function of the observation group was better than that of the control group 4 h after dialysis (P<0.05). There was no statstic difference in pH， Na+， K+and other acid-base balance， electrolyte levels， and bleeding complications between the two groups before and after dialysis (P>0.05). Conclusion： Nafamostat mesylate demonstrates superior anticoagulant efficacy compared to traditional anticoagulants in hemodialysis， with a higher safety profile. NM effectively prevents fibrin deposition during dialysis， maintains the patency of the dialyzer， and reduces bleeding risks.

Key words： ; font-size:medium; ">Hemodialysis； Nafamostat mesylate； Anticoagulant efficacy； Safety； Coagulation function

参考文献

[1] George C， Kengne AP. Advances in the diagnosis， treatment， and prognosis of chronic kidney disease： a reflection on recent developments[J]. Applied Sciences， 2024， 14(13)： 5518.
     [2] Kameda S， Fujii T， Ikeda J， et al. Unfractionated heparin versus nafamostat mesylate for anticoagulation during continuous kidney replacement therapy： an observational study[J]. BMC Nephrol， 2023， 24(1)： 12.
     [3] Kameda S， Maeda A， Maeda S， et al. Dose of nafamostat mesylate during continuous kidney replacement therapy in critically ill patients： a two-centre observational study[J]. BMC Nephrol， 2024， 25(1)： 69.
     [4] Liu D， Zhao J， Xia H， et al. Nafamostat mesylate versus regional citrate anticoagulation for continuous renal replacement therapy in patients at high risk of bleeding： a retrospective single-center study[J]. Eur J Med Res， 2024， 29(1)： 72.
     [5] Wang X， Ji X. Sample size estimation in clinical research： from randomized controlled trials to observational studies[J]. Chest， 2020， 158(1)： S12-S20.
     [6] Vanommeslaeghe F， Van Biesen W， Franois K. Detection and scoring of extracorporeal circuit clotting during hemodialysis[C]//Seminars in Nephrology. WB Saunders， 2024： 151474.
     [7] Smythe MA， Priziola J， Dobesh PP， et al. Guidance for the practical management of the heparin anticoagulants in the treatment of venous thromboembolism[J]. J Thromb Thrombolysis， 2016， 41(1)： 165-186.
     [8] Crowther MA， Warkentin TE. Bleeding risk and the management of bleeding complications in patients undergoing anticoagulant therapy： focus on new anticoagulant agents[J]. Bloody， 2008， 111(10)： 4871-4879.
     [9] 杨振华，陈秋馨，李倩玉，等. 甲磺酸萘莫司他体外抗凝在血液透析高危出血风险患者中的应用观察[J]. 中国血液净化， 2024， 23(9)： 651-654，662.
     [10] Chen P， Zhao LJ， Huang L， et al. Nafamostat mesilate prevented caerulein-induced pancreatic injury by targeting HDAC6-mediated NLRP3 inflammasome activation[J]. Inflamm Res， 2023， 72(9)： 1919-1932.
     [11] 蒋秋艳，王保瑶，张梦婷，等. 甲磺酸萘莫司他抗凝在肾移植术后肾功能延迟恢复患者血液透析中的应用[J]. 中国中西医结合肾病杂志， 2024， 25(8)：698-700.
     [12] Tsujimoto Y， Fujii T. How to prolong filter life during continuous renal replacement therapy?[J]. Critical Care， 2022， 26(1)： 62.
     [13] Qian Y， Wu W， Wang M， et al. How do filter types of renal replacement therapy affect survival in critically ill patients? Concerns about adsorption of nafamostat mesylate on AN69 membranes[J]. BMC Nephrol， 2024， 25(1)： 314.
     [14] Tang JY， Yang L， Wang J， et al. Nafamostat mesylate has advantages as an anticoagulant for patients undergoing maintenance hemodialysis with conjunctival bleeding[J]. Clin Kidney J， 2024， 17(7)：sfae175.
     [15] 陈势，黄嫣然，杨坤. 甲磺酸萘莫司他与枸橼酸在高危出血患者CRRT中抗凝有效性和安全性对比研究[J]. 实用休克杂志(中英文)， 2024， 8 (2)： 89-92，103.
     [16] 庄冰，叶红，曹红娣，等. 注射用甲磺酸萘莫司他用于血液透析抗凝治疗的多中心随机对照研究[J]. 中国血液净化， 2022， 21 (10)： 739-743.

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