van der Steen A
Clin Nephrol. 1986;26 Suppl 1:S39-42.
Until now cellulosic membranes, especially Cuprophan, are still widely applied in the treatment of uremic patients. The success of this type of membrane for routine hemodialysis is related to a number of very useful properties with respect to performance, handling and biocompatibility. However, during dialysis Cuprophan membranes induce transient leucopenia which is closely connected with incidentally occurring pulmonary disfunction. These phenomena are thought to be complement mediated and Cuprophan has been recognized as an activator of complement. Synthetic membranes, such as PAN and PMMA show less complement activation than their cellulosic counterparts. Nevertheless these synthetic membranes cannot meet the performance quality of Cuprophan for routine dialysis and therefore dialyzers with synthetic membranes need special precaution to prevent excessive ultrafiltration. Consequently, research has been focussed on the development of a new cellulose-based dialyzer in which excellent performance suitable for routine dialysis is combined with improved biocompatibility. Two different approaches have been followed for the realization of this objective: The application of thinner membranes and The application of modified cellulose.
直到现在,纤维素膜,尤其是铜仿膜,仍广泛应用于尿毒症患者的治疗。这类膜用于常规血液透析的成功与在性能、操作和生物相容性方面的一些非常有用的特性有关。然而,在透析过程中,铜仿膜会引起短暂性白细胞减少,这与偶尔发生的肺功能障碍密切相关。这些现象被认为是补体介导的,并且铜仿膜已被公认为补体激活剂。合成膜,如聚丙烯腈(PAN)和聚甲基丙烯酸甲酯(PMMA),与纤维素膜相比,补体激活较少。然而,这些合成膜不能满足铜仿膜用于常规透析的性能质量,因此带有合成膜的透析器需要特别预防以防止过度超滤。因此,研究集中在开发一种新型纤维素基透析器,其中适合常规透析的优异性能与改善的生物相容性相结合。为实现这一目标采用了两种不同的方法:应用更薄的膜和应用改性纤维素。