Hirasawa Hiroyuki, Oda Shigeto, Matsuda Kenichi
Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Contrib Nephrol. 2007;156:365-70. doi: 10.1159/000102127.
Continuous hemodiafiltration (CHDF) using a polymethymethacrylate (PMMA) membrane hemofilter (PMMA-CHDF) can effectively and continuously remove various cytokines from the circulating blood. PMMA-CHDF can decrease the blood levels of various cytokines when the blood levels of cytokines are high prior to the initiation of CHDF. The main mechanism of cytokine removal with PMMA-CHDF is the adsorption of cytokines to the hemofilter membrane and this characteristic was not observed in the other membrane material. PMMA-CHDF could improve blood pressure, the depressed monocytic HLA-DR expression, and recover the delayed neutrophil apoptosis in septic patients. Thus, cytokine removal with PMMA-CHDF would be effective for the treatment of severe sepsis and septic shock.
使用聚甲基丙烯酸甲酯（PMMA）膜血液滤过器的连续性血液透析滤过（CHDF，即PMMA-CHDF）能够有效且持续地从循环血液中清除多种细胞因子。当在CHDF开始前细胞因子的血液水平较高时，PMMA-CHDF可降低多种细胞因子的血液水平。PMMA-CHDF清除细胞因子的主要机制是细胞因子吸附至血液滤过器膜，而这一特性在其他膜材料中未观察到。PMMA-CHDF可改善脓毒症患者的血压、降低的单核细胞HLA-DR表达，并恢复延迟的中性粒细胞凋亡。因此，PMMA-CHDF清除细胞因子对严重脓毒症和脓毒性休克的治疗将是有效的。
