高低通量血液透析膜在维持性血液透析过程中的通透性、吸附性和生物相容性  

Low- and high-flux hemodialysis membranes in maintenance hemodialysis: permeability, adsorbability and biocompatibility

作　　者：刘宗旸[1] 谢毅[1] 陈彦[1] 姜燕[1] 顾福熹 

机构地区：[1]贵州省肿瘤医院血液透析室,贵州省贵阳市550001

出　　处：《中国组织工程研究》2015年第38期6190-6194,共5页Chinese Journal of Tissue Engineering Research

基　　金：贵州省卫生计生委科学技术基金项目(gzwjkj2014-2-138):介入联合ACEI治疗在维持性血液透析患者血管通路狭窄或闭塞中的应用及预后观察~~

摘　　要：背景:透析膜是血液透析器最重要的组成部分,透析膜材料的选择直接影响着血液透析的治疗效果。目的:研究高、低通量血液透析膜在维持性血液透析过程中的通透性,吸附性和生物相容性。方法:纳入因慢性肾衰竭行血液透析患者46例,其中男24例,女22例,年龄26-78岁,按随机数表法均分为两组,两组均使用德国贝朗公司生产的Dialog+透析机及碳酸氢盐透析液,透析膜材料分别使用高通量透析膜聚砜膜FX8、低通量透析膜聚砜膜FX60,透析3次/周,4 h/次。透析4个月后,检测两组血液中毒素及炎症因子水平。结果与结论:两组透析后的血尿素氮、血磷、血清肌酐的清除率比较差异无显著性意义;聚砜膜FX60组透析后的血β2-微球蛋白清除率、甲状旁腺素清除率高于聚砜膜FX8组(P<0.05);聚砜膜FX60组透析后的血浆白蛋白及血红蛋白水平均高于聚砜膜FX8组(P<0.05);聚砜膜FX60组透析后的血清白细胞介素8、肿瘤坏死因子a水平低于聚砜膜FX8组(P<0.05)。表明高通量透析膜聚砜膜FX60清除大分子毒素的能力及生物相容性优于低通量透析膜聚砜膜FX8。BACKGROUND： Dialysis membrane is the most important part of a dialyzer, which directly affects the therapeutic efficacy of hemodialysis. OBJECTIVE： To study the permeability, adsorbability and biocompatibility of high- and low-flux hemodialysis membrane in maintenance hemodialysis process. METHODS： Forty-six hemodialysis patients due to chronic renal failure were selected, including 24 males and 22 females, aged 26-78 years. These patients were randomized into two groups： FX8 and FX60 groups. Dialog＋ dialyzer and bicarbonate dialysate（Braun, Germany） were used in the two groups, and polysulfone membranes FX8 and FX60 were respectively used in the two group. All the patients received hemodialysis three times per week, 4 hours once. After 4 months of dialysis, blood levels of toxins and inflammatory cytokines were detected in the two groups. RESULTS AND CONCLUSION： After dialysis, there were no differences in the blood urea nitrogen, serum creatinine, blood phosphorus levels between the two groups. The clearance rates of β2-microglobulin and parathyrin were significantly higher in the FX60 group than the FX8 group（P〈0.05）; the plasma levels of albumin and hemoglobin were significantly higher in the FX60 group than the FX8 group（P〈0.05）; but the serum levels of interleukin-8 and tumor necrosis factor-a were lower in the FX60 group than the FX8 group（P〈0.05）. Thesefindings indicate that high-flux polysulfone membrane FX60 is superior to low-flux polysulfone membrane FX8 in the clearance of macromolecule toxins and biocompatibility.

关 键 词：肾透析 通透性 代谢清除率 生物材料 材料相容性 透析膜 高低通量 血液透析 吸附性 生物相容性 

分 类 号：R318[医药卫生—生物医学工程]