【摘要】目的 比较第二代小分子肝素诺易平与第一代小分子肝素速碧林在血液透析中的抗凝疗效。方法 9例慢性维持性血液透析患者，通过自身交叉对照，分别给速碧林和诺易平血液透析4次，观察透析器凝血情况、尿素氮清除效率、血清Xa活性下降情况及 APTT（活化的部分凝血活酶时间）、每阶段治疗前后血色素改变。结果 应用诺易平后Xa活性下降率明显高于用速碧林后，APTT延长时间则明显短于后者，而透析器凝血情况、尿素氮清除下降率、每阶段治疗前后血色素两组无显著性差异。结论 诺易平较速碧林在血透中做抗凝剂有更好的抗Xa活性及更少的出血危险性。

【Abstract】Objective To investigate the safety and efficiency of the second generation of LMWH Clivarin in chronic hemodialysis. Methods A cross covered trial was made, patients were given Clivarin and Fraxiparine in 4 times HD in different orders. Results The rate of Xa activity of Clivarin group dropped more than Fraxiparine group and APPT was shorter in Clivarin group than that in Fraxiparine group. There were no differences of the decrease of effective urea clearances in the two groups. Conclusion Clivarin provides a more effective anti-Xa activity and a small bleeding risk than Fraxiparine in CHD patients.