甲磺酸萘莫司他用于减少出血高危的维持性血液透析患者出血风险的随机、阳性对照、开放设计的临床研究

注册号:

Registration number:

ChiCTR2600116304 

最近更新日期:

Date of Last Refreshed on:

2026-01-08 09:20:04 

注册时间:

Date of Registration:

2026-01-08 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

甲磺酸萘莫司他用于减少出血高危的维持性血液透析患者出血风险的随机、阳性对照、开放设计的临床研究

Public title:

A Randomized, Active-Controlled, Open-Label Clinical Study of Nafamostat Mesylate for Reducing Bleeding Risk in Maintenance Hemodialysis Patients at High Risk of Bleeding

注册题目简写:

English Acronym:

研究课题的正式科学名称:

甲磺酸萘莫司他用于减少出血高危的维持性血液透析患者出血风险的随机、阳性对照、开放设计的临床研究

Scientific title:

A Randomized, Active-Controlled, Open-Label Clinical Study of Nafamostat Mesylate for Reducing Bleeding Risk in Maintenance Hemodialysis Patients at High Risk of Bleeding

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

雷艳 

研究负责人:

雷艳 

Applicant:

Lei Yan  

Study leader:

Lei Yan  

申请注册联系人电话:

Applicant telephone:

+86 755 81206801

研究负责人电话:

Study leader's
telephone:

+86 755 81206801

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

leiy57@mail.sysu.edu.cn

研究负责人电子邮件:

Study leader's E-mail:

hsxr8308@126.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

中国广东省深圳市光明区新湖街道圳园路628号

研究负责人通讯地址:

中国广东省深圳市光明区新湖街道圳园路628号

Applicant address:

628 Zhenyuan Road, Xinhu Subdistrict, Guangming District, Shenzhen, Guangdong Province, China

Study leader's address:

628 Zhenyuan Road, Xinhu Subdistrict, Guangming District, Shenzhen, Guangdong Province, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

中山大学附属第七医院

Applicant's institution:

The Seventh Affiliated Hospital of Sun Yat-sen University

研究负责人所在单位:

中山大学附属第七医院

Affiliation of the Leader:

The Seventh Affiliated Hospital Sun Yat-sen University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

KY-2025-499-01

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

中山大学附属第七医院(深圳)科研伦理委员会

Name of the ethic committee:

Research Ethics Committee, The Seventh Affiliated Hospital of Sun Yat-sen University (Shenzhen)

伦理委员会批准日期:

Date of approved by ethic committee:

2025-10-30 00:00:00

伦理委员会联系人:

唐燕

Contact Name of the ethic committee:

Tang Yan

伦理委员会联系地址:

中国广东省深圳市光明区新湖街道圳园路628号

Contact Address of the ethic committee:

628 Zhenyuan Road, Xinhu Subdistrict, Guangming District, Shenzhen, Guangdong Province, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 755 81207260

伦理委员会联系人邮箱:

Contact email of the ethic committee:

tangyan2@sysush.com

研究实施负责(组长)单位:

中山大学附属第七医院

Primary sponsor:

The Seventh Affiliated Hospital Sun Yat-sen University

研究实施负责(组长)单位地址:

中国广东省深圳市光明区新湖街道圳园路628号

Primary sponsor's address:

628 Zhenyuan Road, Xinhu Subdistrict, Guangming District, Shenzhen, Guangdong Province, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

广东

市(区县):

Country:

China

Province:

Guangdong

City:

单位(医院):

中山大学附属第七医院

具体地址:

中国广东省深圳市光明区新湖街道圳园路628号

Institution
hospital:

The Seventh Affiliated Hospital of Sun Yat-sen University

Address:

628 Zhenyuan Road, Xinhu Subdistrict, Guangming District, Shenzhen, Guangdong Province, China

经费或物资来源:

广东省卫济医学发展基金会

Source(s) of funding:

Guangdong Weiji Medical Development Foundation

研究疾病:

维持性血液透析  

Target disease:

Maintenance hemodialysis

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

队列研究 

Study design:

Cohort study 

研究目的:

针对同时服用抗凝和/或抗板药、而无抗凝方案禁忌的血液透析患者,如何优化体外抗凝方案,目前尚无统一标准。鉴于目前该类人群的抗凝治疗方案还存在很多争议,因此我们拟设计甲磺酸萘莫司他抗凝治疗对同时使用抗凝和/或抗板药的血液透析患者的前瞻性、随机对照临床研究,探讨甲磺酸萘莫司他抗凝治疗对该类出血高危患者的有效性和安全性,为该患者人群提供一种新的更为安全有效的抗凝方案,使得更多的患者获益。  

Objectives of Study:

There is currently no standardized approach for optimizing extracorporeal anticoagulation in hemodialysis patients who are concurrently receiving anticoagulant and/or antiplatelet therapy and have no contraindications to anticoagulation. Given the ongoing controversies surrounding anticoagulation strategies in this population, we plan to conduct a prospective, randomized controlled clinical trial to evaluate the efficacy and safety of nafamostat mesylate as an anticoagulant in hemodialysis patients receiving concomitant anticoagulant and/or antiplatelet therapy. The aim is to explore a safer and more effective anticoagulation regimen for this high-bleeding-risk group, potentially benefiting a broader patient population.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.对抗凝药物如萘莫司他或者肝素及类似物过敏者; 2.对抗凝药物禁忌,如凝血功能紊乱、活动性出血、肝素诱导血小板减少、对抗凝药物过敏等; 3.预期寿命小于3个月; 4.严重心脏、肝脏、呼吸功能障碍,恶性肿瘤患者; 5.无法或不愿签署书面同意书; 6. 3个月内参加其他临床试验。

Exclusion criteria:

1.Known hypersensitivity to anticoagulants such as nafamostat mesylate, heparin, or heparin analogues.
2.Any contraindication to anticoagulation, including coagulation disorders, active bleeding, heparin-induced thrombocytopenia, or documented allergy to anticoagulant agents.
3.Life expectancy < 3 months.
4.Severe cardiac, hepatic, or respiratory failure; active malignancy.
5.Unable or unwilling to provide written informed consent.
6.Enrollment in any other clinical study within the past 3 months.

研究实施时间:

Study execute time:

From 2026-02-01 00:00:00 To 2027-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-03-31 00:00:00 To 2027-12-31 00:00:00

干预措施:

Interventions:

组别:

依诺肝素抗凝对照组

样本量:

169

Group:

Enoxaparin Anticoagulation Control Group

Sample size:

干预措施:

采用依诺肝素钠抗凝治疗(0.6ml:6000AXaIU/支,天津红日药业股份有限公司),剂量为2000-5000IU,每周透析2-3次,每次3-4小时,治疗开始时启动抗凝治疗。

干预措施代码:

Intervention:

Anticoagulation therapy with sodium enoxaparin (0.6 mL: 6000 AXa IU/vial, Tianjin Hongri Pharmaceutical Co., Ltd.) was administered at a dose of 2000–5000 IU. Hemodialysis was performed 2–3 times per week, each session lasting 3–4 hours, with anticoagulation initiated at the start of treatment.

Intervention code:

组别:

甲磺酸萘莫司他抗凝治疗组

样本量:

169

Group:

Nafamostat Mesylate Anticoagulation Group

Sample size:

干预措施:

采用甲磺酸萘莫司他抗凝治疗,起始剂量为30mg/h(根据ACT结果调整),由江苏杜瑞制药有限公司提供(50mg/支),每周透析2-3次,每次3-4小时,每次治疗开始时启动抗凝治疗。

干预措施代码:

Intervention:

Anticoagulation therapy with nafamostat mesylate was administered, with an initial dose of 30 mg/h (adjusted based on ACT results), provided by Jiangsu Duer Pharmaceutical Co., Ltd. (50 mg/vial). Hemodialysis was performed 2–3 times per week, each session lasting 3–4 hours, and anticoagulation was initiated at the beginning of each treatment.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China

Province:

Guangdong

City:

单位(医院):

中山大学附属第七医院 

单位级别:

三级甲等 

Institution
hospital:

The Seventh Affiliated Hospital of Sun Yat-sen University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

不良反应

指标类型:

次要指标

Outcome:

Adverse events

Type:

Secondary indicator

测量时间点:

测量方法:

观察甲磺酸萘莫司他抗凝与常规低分子肝素抗凝组患者的不良反应(血常规、电解质、酸碱度、白蛋白等)。

Measure time point of outcome:

Measure method:

To compare the incidence of adverse reactions—specifically changes in complete blood count, electrolytes, acid–base status and albumin—between patients receiving nafamostat-mesylate anticoagulation and those receiving conventional low-molecular-weight heparin (LMWH) during maintenance hemodialysis.

指标中文名:

抗凝效果

指标类型:

次要指标

Outcome:

Anticoagulant efficacy

Type:

Secondary indicator

测量时间点:

测量方法:

比较甲磺酸萘莫司他抗凝与常规低分子肝素抗凝组患者的抗凝效果(治疗时间、透析器及静脉壶/动脉壶的堵塞分度)。

Measure time point of outcome:

Measure method:

To compare the anticoagulant efficacy of nafamostat mesylate versus conventional low-molecular-weight heparin (LMWH) in maintenance hemodialysis patients, we will assess: Total treatment time per session Dialyzer clotting grade Venous and arterial chamber clotting grade

指标中文名:

透析充分性

指标类型:

次要指标

Outcome:

Dialysis adequacy

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

大出血事件的发生率

指标类型:

主要指标

Outcome:

The incidence of major bleeding events

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

非大出血事件的发生率

指标类型:

次要指标

Outcome:

The incidence of non-major bleeding events

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

指标类型:

主要指标

Outcome:

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

Blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 75 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

使用 PASS 软件,采用区组随机化,由专门的统计师生成随机编码表。

Randomization Procedure (please state who generates the random number sequence and by what method):

Using the PASS software, block randomization was employed, and a randomized code table was generated by a dedicated statistician.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

开放标签

Blinding:

Open-label study

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

华墨电子系统

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Huamo Electronic System

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

CRF表和EDC均采用电子模式,专人管理

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Both the CRF and EDC are fully electronic and managed by designated personnel.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

无/No

注册人:

Name of Registration:

 2026-01-08 09:19:56