Splendiani G, Albano V, Tancredi M, Daniele M, Pignatelli F
S. Salvatore University Hospital, L'Aquila Italy.
Biomater Artif Cells Artif Organs. 1987;15(1):175-81. doi: 10.3109/10731198709118517.
Hemodialysis can remove only substances that are highly diffusable, non protein bound and with small and middle-molecular weights. The combination of Hemodialysis-Hemoperfusion (HD-HF) takes advantage of both techniques. Uremic patient could reduce the number of weekly dialysis sessions. Fourteen uremic patients were submitted twice a week to a combined HD-HP treatment for 16 months. Polymethacrylate coated charcoal was inserted in the dialysis circuit before the dialyzer. The treatment resulted in improvement of: MNCV (30.5 + -6 to 38.7 + -5.6 m/sec.) subjective symptoms (disappearance of pruritus and insomnia) and hematological status (red blood cells 3.1 x 106 to 4.02 x 106; and hematocrits 28.3 to 36.1). Good control of serum biochemistries. Creatinine and urea clearances of 228 and 236 ml/min respectively. Significant removal of middle-molecules uremic toxins determinated by gel-filtration on Sephadex G15. In conclusion, we state that combined HD-HP improves the detoxication possibilities in chronic uremia.
血液透析只能清除高度可扩散、非蛋白结合且分子量小和中等的物质。血液透析 - 血液灌流（HD - HF）联合治疗结合了两种技术的优势。尿毒症患者可以减少每周透析次数。14例尿毒症患者每周接受两次HD - HP联合治疗，持续16个月。在透析器之前将聚甲基丙烯酸酯包被的活性炭插入透析回路。治疗导致以下方面得到改善：运动神经传导速度（从30.5±6提高到38.7±5.6米/秒）、主观症状（瘙痒和失眠消失）以及血液学状态（红细胞从3.1×10⁶提高到4.02×10⁶；血细胞比容从28.3提高到36.1）。血清生化指标得到良好控制。肌酐清除率和尿素清除率分别为228和236毫升/分钟。通过Sephadex G15凝胶过滤法测定，可有效清除中等分子量的尿毒症毒素。总之，我们认为HD - HP联合治疗可提高慢性尿毒症的解毒能力。
