一种在恶性腹水患者的无细胞浓缩腹水回输治疗中稳定白蛋白还原形式比例的方法。

A Method for Stabilizing the Proportion of the Reduced Form of Albumin During Cell-Free and Concentrated Ascites Reinfusion Therapy in Patients with Malignant Ascites.

作者信息

Ohashi Atsushi, Nakai Shigeru, Yamada Sachie, Kato Masao, Hasegawa Midori

机构信息

Faculty of Clinical Engineering, School of Medical Sciences, Fujita Health University, Toyoake, Japan.

Center of Blood Purification, Fujita Health University, Toyoake, Japan.

出版信息

Ther Apher Dial. 2019 Jun;23(3):242-247. doi: 10.1111/1744-9987.12827. Epub 2019 May 26.

DOI:10.1111/1744-9987.12827

PMID:31033167

Abstract

Cell-free and concentrated ascites reinfusion therapy (CART) is used to treat malignant ascites. However, the qualities of albumin in malignant ascites, such as antioxidative activity, may decrease owing to oxidative stress caused by cancer cells and inflammatory reactions. We investigated the fraction percentages of mercaptalbumin (HMA%, reduced form) and non-mercaptalbumin (HNA%, oxidized form) in malignant ascites from 21 patients who received CART and compared the HMA% in the malignant ascites and human serum albumin (HSA) preparations. HMA% of albumin in malignant ascites (22.5%) was significantly lower than that in HSA preparation (42.2%). To ensure a high HMA%, we added L-cysteine to the paracentesis-treated ascites followed by dialysis 1 h later. As a result, the HMA% of albumin in malignant ascites was increased to 59.1%. Our results suggest that using this method in CART will improve patient's albumin quality.

摘要

无细胞浓缩腹水回输疗法（CART）用于治疗恶性腹水。然而，恶性腹水白蛋白的质量，如抗氧化活性，可能会因癌细胞引起的氧化应激和炎症反应而降低。我们调查了21例接受CART治疗患者的恶性腹水中巯基白蛋白（HMA%，还原形式）和非巯基白蛋白（HNA%，氧化形式）的比例，并比较了恶性腹水和人血清白蛋白（HSA）制剂中的HMA%。恶性腹水中白蛋白的HMA%（22.5%）显著低于HSA制剂中的HMA%（42.2%）。为确保高HMA%，我们在穿刺处理后的腹水中加入L-半胱氨酸，1小时后进行透析。结果，恶性腹水中白蛋白的HMA%增加到了59.1%。我们的结果表明，在CART中使用这种方法将改善患者白蛋白的质量。