Omokawa S, Malchesky P S, Yamashita M, Goldcamp J B, Nosé Y
Department of Artificial Organs, Cleveland Clinic Foundation, Ohio 44106.
ASAIO Trans. 1988 Jul-Sep;34(3):404-9.
Heparin (H) and citrate (C) anticoagulation with cellulose acetate (CA) and polyvinyl chloride (PVC) membrane devices were evaluated on three myasthenia gravis patients. Changes of white blood cell (WBC) and platelet (PLT) counts, complement activation, granulocyte elastase, and interleukin-1 beta (IL-1 beta) were studied sequentially. Changes in WBC and PLT counts were more dependent on the membrane material and surface area. Changes of C3a and C5a were more related to the anticoagulant used, whereas changes of C4a were membrane-material dominant phenomenon. Systemic elastase levels did not show significant differences among the groups but module outlet values were elevated for Ca + H. IL-1 beta did not show changes in all schemes. CA + H was the most activating and PVC + C was the least activating combination. Both the membrane materials and anticoagulant must be considered in evaluating humoral and blood cellular changes in plasmapheresis.
对三名重症肌无力患者使用醋酸纤维素（CA）和聚氯乙烯（PVC）膜装置进行肝素（H）和枸橼酸盐（C）抗凝评估。依次研究白细胞（WBC）和血小板（PLT）计数、补体激活、粒细胞弹性蛋白酶和白细胞介素 -1β（IL-1β）的变化。WBC和PLT计数的变化更依赖于膜材料和表面积。C3a和C5a的变化与所用抗凝剂的关系更大，而C4a的变化是以膜材料为主导的现象。各组间全身弹性蛋白酶水平无显著差异，但钙加肝素（Ca + H）的模块出口值升高。IL-1β在所有方案中均未显示变化。CA + H是最具激活作用的组合，而PVC + C是激活作用最小的组合。在评估血浆置换中的体液和血细胞变化时，必须同时考虑膜材料和抗凝剂。
