Ueda M, Deguchi M, Takemura S, Kasamatsu Y, Yanagida K, Fukuda W, Okamoto M, Onodera H, Sugino S, Kondo M
First Department of Internal Medicine, Kyoto Prefectural University of Medicine, Karasumaichijo Hospital.
Nihon Jinzo Gakkai Shi. 1990 Jan;32(1):19-24.
The kinetics of hemodialysis-induced leukopenia and generation of complement fragments including C3a, C5a, C4d, iC3b and Bb were investigated in 14 patients during hemodialysis using cellulose acetate (CA), cuprophan (Cu) and ethylenevinyl alcohol (EVA) membranes. A marked leukopenia in the first 15 minutes was observed in CA and Cu. Plasma C3a levels were higher in CA than in Cu and EVA. Plasma C5a levels were higher in CA and Cu than in EVA. There was a negative correlation between the white blood cell counts and plasma C5a levels at 15 minutes (gamma = -0.85, p less than 0.001). Plasma C4d levels showed no increase in all membranes. Plasma iC3b levels were higher significantly in Cu than in CA and EVA. Plasma Bb levels in the first 15 minutes increased significantly in all membranes, and furthermore continued to increase till the end of hemodialysis in CA and Cu. This study revealed that all the membranes tested activated the complement via the alternative pathway to produce Bb, iC3b, C3a and C5a. C5a was thought to take an important role in transient leukopenia. Furthermore, Bb was accumulated during hemodialysis in CA and Cu, and its biological effects on patients undergoing hemodialysis should be studied.
在14例接受血液透析的患者中，使用醋酸纤维素（CA）、铜仿膜（Cu）和乙烯-乙烯醇共聚物（EVA）膜，研究了血液透析诱导白细胞减少的动力学以及补体片段C3a、C5a、C4d、iC3b和Bb的生成情况。在使用CA和Cu膜进行血液透析的最初15分钟内，观察到明显的白细胞减少。CA组血浆C3a水平高于Cu组和EVA组。CA组和Cu组血浆C5a水平高于EVA组。在15分钟时，白细胞计数与血浆C5a水平呈负相关（γ=-0.85，p<0.001）。所有膜组的血浆C4d水平均未升高。Cu组血浆iC3b水平显著高于CA组和EVA组。在最初15分钟内，所有膜组的血浆Bb水平均显著升高，并且在使用CA和Cu膜进行血液透析至结束时持续升高。该研究表明，所有测试的膜均通过替代途径激活补体，产生Bb、iC3b、C3a和C5a。C5a被认为在短暂性白细胞减少中起重要作用。此外，在使用CA和Cu膜进行血液透析期间，Bb会蓄积，应对其对接受血液透析患者的生物学效应进行研究。
