Kandus A, Ponikvar R, Drinovec J, Pavlin K, Ivanovich P
Department of Nephrology, University Medical Center, Ljubljana, Yugoslavia.
Int J Artif Organs. 1990 Apr;13(4):200-4.
Elimination characteristics of beta 2-microglobulin (BMG) during hemofiltration (HF) with acrylonitrile (AN69) and polysulfone (PS) hemofilters were investigated in a prospective clinical investigation. Seven chronic uremics on regular HF were treated for 4 weeks, three times a week, with AN69 hemofilters. The study was then repeated with PS hemofilters. There were no significant differences in the patients' body weight, the ultrafiltrate volume per session, and the duration of each HF session between both treatments. At the start of HF, arterial plasma concentration of BMG was (for AN69) 33.5 +/- 4.0 mg/L (mean +/- SD) and (for PS) 35.8 +/- 6.5 mg/L (NS); at the end of HF it was (for AN69) 11.0 +/- 1.8 mg/L and (for PS) 17.5 +/- 4.2 mg/L (p less than 0.001). The amount of BMG in total ultrafiltrate was (for AN69) 179.3 +/- 22.6 mg and (for PS) 140.6 +/- 26.8 mg (p less than 0.02). With AN69 hemofilter, maximum BMG plasma clearance and sieving coefficient were 51.0 +/- 9.5 mL/min and 0.42 +/- 0.04 at 60 minutes. With PS hemofilter, maximum BMG plasma clearance and sieving coefficient were 37.4 +/- 5.7 mL/min and 0.27 +/- 0.03 at 15 minutes. Twenty-two percents of BMG entering the AN69 hemofilter at 15 minutes were adsorbed on the membrane (p less than 0.001). BMG elimination with the AN69 hemofilter was more efficient than with the PS hemofilter. Long-term studies will be necessary to demonstrate whether this difference is of any clinical significance.
在一项前瞻性临床研究中,研究了使用丙烯腈(AN69)和聚砜(PS)血液滤过器进行血液滤过(HF)期间β2-微球蛋白(BMG)的清除特性。7名接受常规血液滤过的慢性尿毒症患者,每周进行3次,使用AN69血液滤过器治疗4周。然后使用PS血液滤过器重复该研究。两种治疗之间患者的体重、每次治疗的超滤量以及每次血液滤过治疗的持续时间均无显著差异。血液滤过开始时,动脉血浆BMG浓度(AN69组)为33.5±4.0mg/L(平均值±标准差),(PS组)为35.8±6.5mg/L(无显著性差异);血液滤过结束时,(AN69组)为11.0±1.8mg/L,(PS组)为17.5±4.2mg/L(p<0.001)。总超滤液中BMG的量(AN69组)为179.3±22.6mg,(PS组)为140.6±26.8mg(p<0.02)。使用AN69血液滤过器时,60分钟时最大BMG血浆清除率和筛系数分别为51.0±9.5mL/min和0.42±0.04。使用PS血液滤过器时,15分钟时最大BMG血浆清除率和筛系数分别为37.4±5.7mL/min和0.27±0.03。15分钟时进入AN69血液滤过器的BMG中有22%被吸附在膜上(p<0.001)。使用AN69血液滤过器清除BMG比使用PS血液滤过器更有效。需要进行长期研究以证明这种差异是否具有任何临床意义。