Kandus A, Ponikvar R, Drinovec J, Kladnik S, Ivanovich P
Department of Nephrology, University Medical Center, Ljubljana, Yugoslavia.
Int J Artif Organs. 1990 Mar;13(3):176-80.
We studied the adsorption of anaphylatoxins C3a and C5a on acrylonitrile (AN69) hollow-fiber (AN69HF) and plate (AN69P) dialyzers in 8 patients during 4-hour hemodialyses (HD). Blood passed first through a cuprophan dialyzer and then through AN69 dialyzers that were not in contact with dialysis fluid. Plasma C3a and C5a were measured in samples taken from the afferent and efferent blood lines of the acrylonitrile dialyzers at 15, 60 and 240 min. Plasma C3a concentrations decreased significantly in blood that had passed through AN69 dialyzers. This decrease, indicating membrane adsorption, was maximal (by 65% in AN69HF and by 59% in AN69P) at 15 min and minimal (by 53% in AN69HF and by 18% in AN69P) at 240 min. The decrease in plasma C5a concentrations was smaller and significant throughout HD only with AN69HF. The amount of C3a adsorbed was at least 45,000 micrograms in AN69HF and 18,000 micrograms in AN69P. These findings demonstrate that acrylonitrile dialyzers adsorb more C3a and C5a than they produce. This membrane adsorption may explain why the increase of plasma C3a and C5a is inhibited during HD.
我们研究了8例患者在4小时血液透析(HD)过程中过敏毒素C3a和C5a在丙烯腈(AN69)中空纤维(AN69HF)和平板(AN69P)透析器上的吸附情况。血液首先通过铜仿膜透析器,然后通过不与透析液接触的AN69透析器。在15、60和240分钟时,从丙烯腈透析器的入血和出血管路采集样本,检测血浆C3a和C5a。通过AN69透析器的血液中血浆C3a浓度显著降低。这种表明膜吸附的降低在15分钟时最大(AN69HF中降低65%,AN69P中降低59%),在240分钟时最小(AN69HF中降低53%,AN69P中降低18%)。仅在使用AN69HF进行血液透析的整个过程中,血浆C5a浓度的降低幅度较小且具有显著性。AN69HF中吸附的C3a量至少为45000微克,AN69P中为18000微克。这些发现表明,丙烯腈透析器吸附的C3a和C5a比其产生的更多。这种膜吸附可能解释了为什么在血液透析过程中血浆C3a和C5a的增加受到抑制。