Lindsay R M, Spanner E, Heidenheim A P, Lindsay S, LeFebvre J M
Department of Medicine, Victoria Hospital, London, Ontario, Canada.
ASAIO Trans. 1991 Jul-Sep;37(3):M134-5.
It has been hypothesized that the protein catabolic rate (PCR) is dependent upon the amount [Kt/V (urea)] and the type of dialysis (synthetic vs. cellulosic membrane). In an ongoing multicenter study comparing short hour-high flux with conventional cellulosic dialysis, 49 patients have completed 6 months and serial urea kinetic data has been obtained. Of the 49, 28 were on AN69S membrane dialyzers, and 21 on cellulosic. The patients on AN69S received significantly less Kt/V than those on cellulosic dialyzers (0.97 +/- 0.3 vs. 1.20 +/- 0.2; p = 0.0016), yet attained similar PCRs (1.07 +/- 0.2 vs. 1.02 +/- 0.1, NS). Significant (p = 0.002) linear relationships between PCR and Kt/V (urea) were found, yet the line slopes were higher for AN69S (average 0.46) than cellulose (average 0.25). Patients on AN69S achieve the same PCR for less Kt/V than patients on cellulosic dialyzers, supporting the hypothesis.
据推测，蛋白质分解代谢率（PCR）取决于尿素清除率[Kt/V（尿素）]的数值以及透析类型（合成膜与纤维素膜）。在一项正在进行的多中心研究中，比较了短时间高通量透析与传统纤维素透析，49例患者已完成6个月的治疗，并获得了系列尿素动力学数据。这49例患者中，28例使用AN69S膜透析器，21例使用纤维素膜透析器。使用AN69S膜透析器的患者所接受的Kt/V显著低于使用纤维素膜透析器的患者（0.97±0.3对1.20±0.2；p = 0.0016），然而却达到了相似的PCR值（1.07±0.2对1.02±0.1，无显著差异）。发现PCR与Kt/V（尿素）之间存在显著的（p = 0.002）线性关系，但AN69S膜的直线斜率（平均0.46）高于纤维素膜（平均0.25）。与使用纤维素膜透析器的患者相比，使用AN69S膜透析器的患者以更低的Kt/V达到相同的PCR，这支持了上述假设。
