中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (34): 6453-6456.doi: 10.3969/j.issn.1673-8225.2010.34.045

• 生物材料学术探讨 biomaterial academic discussion • 上一篇    下一篇

不同透析膜材料在维持性血液透析过程中的生物相容性

石  磊   

  1. 湖北民族学院附属医院肾内科 湖北省恩施市 445000
  • 出版日期:2010-08-20 发布日期:2010-08-20
  • 作者简介:石磊，1969年生，湖北省利川市人，1991年毕业于武汉大学医学院，副主任医师，主要研究方向：肾脏病内科学。 fyywk690928@163.com

Biocompatibility of different dialysis membrane materials in maintenance hemodialysis process

Shi Lei   

  1. Department of Nephrology, Affiliated Hospital of Hubei Institute for Nationalities, Enshi   445000, Hubei Province, China
  • Online:2010-08-20 Published:2010-08-20
  • About author:Shi Lei, Associate chief physician, Department of Nephrology, Affiliated Hospital of Hubei Institute for Nationalities, Enshi 445000, Hubei Province, China fyywk690928@163.com

PDF

1860

被引次数

22

摘要：

目的：对聚砜膜、血仿膜和醋酸纤维膜在维持性血液透析中的应用进行综合评价，以选择适宜的透析膜材料进行血液透析。
方法：电子检索中国期刊全文数据库(CNKI：1990/2008)，以“透析膜，相容性，并发症”为检索词收集关于不同透析膜材料的临床应用文献共50篇，排除综述类文献、实验研究及透析膜清洗等文献，共纳入22篇关于不同透析膜溶质清除率及生物相容性评价的文献，对不同材料的血液透析膜的临床应用情况进行全面总结。
结果：通过对聚砜膜、血仿膜和醋酸纤维膜在维持性血液透析中的溶质清除率的分析得出，聚砜膜、血仿膜对全段甲状旁腺激素、血磷、血钙的清除效果优于醋酸纤维膜，对于B细胞活化的血清CD23清除效果优于醋酸纤维膜，对血小板活化程度的影响弱于醋酸纤维膜。高通透量的聚砜膜不增加炎症反应，醋酸纤维膜透析的P选择素的水平高于聚砜膜和血仿膜，3种透析膜的血清胱抑素C清除率无差异。
结论：聚砜膜、血仿膜和醋酸纤维膜对血清CD23浓度、血小板活化程度、炎症反应、出凝血并发症、血清P选择素水平均的影响与其生物相容性有关:生物相容性越好，对血清CD23浓度水平、血小板活化程度、炎症反应、出凝血并发症、血清P选择素水平的影响越小，反之则大，聚砜膜和血仿膜生物相容性好于醋酸纤维膜，血仿膜的血液透析并发症最少。

关键词: 聚砜膜, 血仿膜, 醋酸纤维膜, 血液透析, 溶质清除率, 生物相容性, 并发症

Abstract:

OBJECTIVE: To comprehensively evaluate the application of polysulfone membrane, hemophan membrane and cellulose acetate membrane in the process of maintenance hemodialysis, to select appropriate membranes for hemodialysis.
METHODS: Chinese Academic Journal Full-text Database (CNKI: 1990/2008) was retrieved for articles related to the clinical application of different dialysis membranes using “dialysis membrane, compatibility, complications” in Chinese as the key words, totally 50 articles were screened out. Reviews, experimental studies and articles on dialysis membrane cleaning were excluded, 22 articles related to solute clearance rate and biocompatibility of different dialysis membranes were included, the clinical application of blood dialysis membranes of different materials was comprehensively summarized.
RESULTS: Based on the analysis of solute clearance of polysulfone membrane, hemophan membrane and cellulose acetate membrane in maintenance hemodialysis, the effect of polysulfone membrane and hemophan membrane on clearing intact parathyroid hormone, phosphorus, calcium was better than that of cellulose acetate membrane, the clearance of B cell activated serum CD23 was better than cellulose acetate membrane. As for the platelet activation, the two were weaker than cellulose acetate membrane. Polysulfone membrane with high permeability does not increase inflammation, P-selectin levels dialysis by cellulose acetate membrane were higher than polysulfone membrane and hemophan membrane, three kinds of dialysis membranes had no significant difference on serum cystatin C clearance rate.
CONCLUSION: The effects of polysulfone membrane, hemophan membrane and cellulose acetate membrane on serum CD23 concentration, platelet activation, inflammatory response, clotting complications, P-selectin serum levels were related to the biocompatibility: better biocompatibility indicated few effects, otherwise indicated greater effects. The biocompatibility of polysulfone membrane and hemophan membrane is better than cellulose acetate membrane, of complications of hemodialysis membrane are at least in hemophan membrane.

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