Davenport A, Williams A J
Department of Renal Medicine, Royal Liverpool Hospital, U.K.
Respir Med. 1990 Jan;84(1):17-21. doi: 10.1016/s0954-6111(08)80088-1.
Peak expiratory flow rates were measured during routine haemodialysis in 18 patients with chronic renal failure who were in receipt of thrice weekly haemodialysis treatment, using both a new cuprophan dialyzer and then the same dialyzer after reprocessing. Acetate buffered dialysate was used on both occasions. The peak expiratory flow rates fell by 10 +/- 0.3%, mean +/- sem, during the first hour of treatment with the new dialyzer, and in seven patients (39%) the fall was greater than 15%. Whereas the reduction in peak expiratory flow rates was significantly less with reuse, 4 +/- 0.1% (P less than 0.5). Similarly, the fall in arterial oxygen tension was also reduced on reuse from 28 +/- 1.2% to 14 +/- 1.3% at 30 min (P less than 0.05) and from 30 +/- 1.4% to 18 +/- 3.1% (P less than 0.05) at 60 min of dialysis. There was also a reduction in the fall in the peripheral platelet count at 30 min of dialysis from 14 +/- 0.8% to 9 +/- 0.4% with reuse (P less than 0.05). However, there was no change in dialysis associated leukopenia with reuse of the dialyzer membrane. These results suggest that reprocessing the dialyzer membrane alters its biocompatibility characteristics resulting in an improvement in biocompatibility and further supports the role of inflammatory cell mediator release in the pathogenesis of dialysis associated hypoxaemia and pulmonary dysfunction during the first hour of dialysis treatment.
在接受每周三次血液透析治疗的18例慢性肾衰竭患者进行常规血液透析期间，分别使用新型铜仿膜透析器以及同一透析器再处理后，测量呼气峰值流速。两次均使用醋酸盐缓冲透析液。使用新型透析器治疗的第一个小时内，呼气峰值流速下降了10±0.3%（平均值±标准误），7例患者（39%）下降幅度超过15%。而透析器复用后呼气峰值流速的下降明显减少，为4±0.1%（P<0.5）。同样，复用后动脉血氧分压的下降在透析30分钟时也从28±1.2%降至14±1.3%（P<0.05），在透析60分钟时从30±1.4%降至18±3.1%（P<0.05）。透析30分钟时外周血小板计数的下降也因复用而从14±0.8%降至9±0.4%（P<0.05）。然而，透析器膜复用后与透析相关的白细胞减少没有变化。这些结果表明，透析器膜的再处理改变了其生物相容性特征，从而改善了生物相容性，并进一步支持了炎症细胞介质释放在透析治疗第一小时内透析相关低氧血症和肺功能障碍发病机制中的作用。
