Goldman M, Lietaer N, Lambert P, Thayse C, Vanherweghem J L
Department of Nephrology, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Belgium.
Life Support Syst. 1987 Oct-Dec;5(4):317-22.
We analysed the impact of the area of the dialysis membrane and of its content in hydroxyl moieties on the magnitude of haemodialysis-induced complement activation and leucopenia. First, in five patients successively treated with cellulose acetate membranes of different areas, we found that increase of the area results in an increase in complement activation determined by C3a levels before and at 15 min of dialysis. The levels of leucopenia were similarly affected, and a significant correlation was found between complement activation and leucopenia (r = 0.89, P less than 0.05). When we compared the biocompatibility characteristics of a dialyser made of saponified cellulose ester with those of two dialysers made of cellulose acetate, we found that index of complement activation (18.1 +/- 2 vs 9.9 +/- 1.1 and 11.5 +/- 1.1, P less than 0.01) as well as index of leucopenia (69 +/- 4 vs 40 +/- 2 and 37 +/- 3, P less than 0.001) were significantly higher on the saponified cellulose ester dialysers suggesting that hydroxyl groups of cellulosic membranes play an important role in the pathophysiology of dialysis-induced changes.
我们分析了透析膜面积及其羟基含量对血液透析诱导的补体激活程度和白细胞减少的影响。首先，在五名先后使用不同面积醋酸纤维素膜进行治疗的患者中，我们发现透析膜面积增加会导致透析前及透析15分钟时由C3a水平测定的补体激活增加。白细胞减少的程度也受到类似影响，并且在补体激活与白细胞减少之间发现了显著相关性（r = 0.89，P < 0.05）。当我们比较由皂化纤维素酯制成的透析器与由醋酸纤维素制成的两种透析器的生物相容性特征时，我们发现补体激活指数（18.1±2对比9.9±1.1和11.5±1.1，P < 0.01）以及白细胞减少指数（69±4对比40±2和37±3，P < 0.001）在皂化纤维素酯透析器上显著更高，这表明纤维素膜的羟基在透析诱导变化的病理生理学中起重要作用。
