Bosch T, Schmidt B, Samtleben W, Gurland H J
Clin Nephrol. 1986;26 Suppl 1:S22-9.
A new modified cellulose dialysis membrane (MC, 1.2 m2) in which less than 5% of cellulosic OH-groups are substituted by tertiary amino groups was tested in a 6-week clinical trial for biocompatibility and clinical performance and compared to both regenerated cellulose (RC, 1.2 m2) and cellulose acetate (CA, 1.0 m2). Ten patients on maintenance hemodialysis took part in the study; all hollow fiber modules were equally well tolerated and no adverse reactions were observed. Using MC/RC/CA, mean clearances after 15 min of hemodialysis (HD) amounted to 162/169/150 ml/min for urea, to 143/143/124 ml/min for creatinine, and to 104/107/84 ml/min for phosphate (QB = 200 ml/min, QD = 500 ml/min, UFR = 0). Mean drop of systolic blood pressure was 6/10/8 mmHg and mean decrease of heart rate averaged 3/3/3 beats per minute, respectively, during the first hour of HD as compared to starting conditions. Residual blood volume in the modules after HD was low and heparin consumption identical for all 3 membranes (34 IU/kg X h). Mean peak C3a generation for MC/RC/CA amounted to 1312/3486/3099 ng/ml, respectively; leucocyte and platelet counts dropped to a minimum of 67/24/47% and 81/86/91%, respectively during the first hour of HD as compared to initial values. Elastase release from PMNL and platelet factor 4 from platelets showed no significant differences between the membranes. In conclusion, the new MC membrane showed a significantly better biocompatibility and equally good clinical performance as compared to RC and CA.
一种新型改性纤维素透析膜(MC,1.2平方米),其中不到5%的纤维素羟基被叔氨基取代,在一项为期6周的临床试验中对其生物相容性和临床性能进行了测试,并与再生纤维素(RC,1.2平方米)和醋酸纤维素(CA,1.0平方米)进行了比较。10名维持性血液透析患者参与了该研究;所有中空纤维组件的耐受性均良好,未观察到不良反应。使用MC/RC/CA,血液透析(HD)15分钟后的平均清除率,尿素分别为162/169/150毫升/分钟,肌酐为143/143/124毫升/分钟,磷酸盐为104/107/84毫升/分钟(QB = 200毫升/分钟,QD = 500毫升/分钟,超滤率 = 0)。与起始状态相比,HD第一小时内收缩压平均下降6/10/8毫米汞柱,心率平均下降分别为每分钟3/3/3次。HD后组件中的残余血量较低,所有3种膜的肝素消耗量相同(34国际单位/千克×小时)。MC/RC/CA的平均C3a峰值生成量分别为1312/3486/3099纳克/毫升;与初始值相比,HD第一小时内白细胞和血小板计数分别降至最低67/24/47%和81/86/91%。中性粒细胞释放弹性蛋白酶和血小板释放血小板因子4在各膜之间无显著差异。总之,与RC和CA相比,新型MC膜显示出显著更好的生物相容性和同样良好的临床性能。