脂质体血液透析清除蛋白结合性毒素的初步试验  

Preliminary examination on removal of protein-bound toxins by hemolipodialysis

作　　者：施雪枫[1] 丁峰[1] 顾勇[1] 朱秋毓[1] 潘俊[2] 陆伟跃[2] 

机构地区：[1]复旦大学附属华山医院肾病科,上海200040 [2]复旦大学药学院靶向制剂室,上海200032

出　　处：《复旦学报（医学版）》2006年第2期213-216,共4页Fudan University Journal of Medical Sciences

基　　金：回国留学人员启动基金

摘　　要：目的体外试验条件下模拟血液透析,观察脂质体血液透析(HLD)对蛋白结合性溶质的清除效果,并与常规血液透析和白蛋白透析进行比较。方法采用体外闭合循环,分别于血液侧(B侧)加入含3-硫酸吲哚酚(IS),胆红素(Bil)和胆酸钠(CA)的牛血清白蛋白(BSA)溶液。根据透析液侧(D侧)成分分为对照组(生理盐水),白蛋白组(BSA生理盐水溶液)和脂质体组(4%大豆卵磷脂脂质体生理盐水溶液),每组进行3次150min体外循环,每30min分别由两侧取样测定溶质浓度及白蛋白水平。结果白蛋白组中IS在30min即达到两侧平衡,脂质体组和对照组中IS分别在90min^120min和150min时两侧溶质浓度接近。CA在白蛋白组和脂质体组中清除较快;对照组中B侧CA水平则在60min^90min已达平台,而其D侧含量维持于低水平。Bil的清除曲线与CA类似,但在脂质体组中60min后才显示逐渐下降。各组中BSA含量在30min轻度下降外,其后则无明显变化。结论与常规血液透析方式相比,HLD和白蛋白透析能更有效清除蛋白结合性溶质,而HLD起效较慢但效应更持久。Purpose To examine the effects on clearance of protein-bound solutes by hemolipodialysis （HLD） via extracorporeal circuit, in comparison with albumin hemodialysis and conventional process. Methods In vitro models of close circuits were established, and the assumptive blood compartment （B side） was filled with bovine serum albumin（BSA） solution containing 3-indoxyl sulphate（IS）, bilirubin（Bil） and sodium cholate（CA）, respectively. Based on the component in dialysate compartment（D side）, the experiments were assorted into control（normal saline）, albumin （BSA/normal saline solution）and liposome （4 % soybean lecithin liposome/normal saline solution） group. Each group consisted of three 150min sessions of circuit and samples were drawn on both sides every 30 minutes during the course for determining toxins and albumin. Results IS elimination finished at 150min in control group, at 30 min in albumin group and at 90min-120min in liposome group. Removal of CA was more rapid in albumin and liposome group, and a platform was observed in its removal curve at 60min - 90min, while CA concentration on D side kept low in control group. Clearance of bilirubin was similar to that of CA, except that no drop occurred during the first 60 min. BSA remained nearly stable despite a slight decrease during the first 30 min. Conclusions Hemolipodialysis as well as albumin dialysis is more efficient on removing protein-bound solutes than conventional hemodialysis, and the effect of HLD may come later but last for a longer while.

关 键 词：脂质体血液透析 蛋白结合性毒素 白蛋白 

分 类 号：R459.5[医药卫生—治疗学]