Grekas D, Syrganis C, Georgiou T, Zegla O, Tourkantonis A
First Medical Department, University of Thessaloniki, Hospital AHEPA, Greece.
Life Support Syst. 1985;3 Suppl 1:68-72.
The study is a comparison of 4 successive hemodialysis (HD) sessions on each patient, 2 with cuprophan (CU) membrane (Gambro 120 M) and 2 with Cellulose acetate (CA) (Cordis Dow 3500). 60 minutes prior to the HD session placebo or Ticlopidine (500 mg) was administered orally to each patient. Leucocyte and platelet counts, serum C3 complement, arterial PO2, PCO2 and PH were measured before and 15, 30, 60, 120 and 240 minutes after the beginning of HD. Leucocyte count fell markedly within 15 minutes of both placebo HD sessions, but it was significantly lower (p less than 0.005) in CA than CU membrane. Ticlopidine prevented significantly (p less than 0.01) the HD-induced leucopenia. Slight changes in platelet count, either in placebo or Ticlopidine study were observed. Serum C3 complement increased significantly (p less than 0.05) at 15 minutes of CU placebo session and was also correlated (p less than 0.01) with the concurrent leucopenia. The arterial PO2 decreased 22% and 13.5% during HD with CU and CA membranes respectively, but it was preserved within normal limits by Ticlopidine. The arterial PH was increased up to 7.4 at the end of all HD sessions, while PCO2 showed only slight changes. We conclude that: 1) CA membrane is better tolerated than CU 2) HD-induced leucopenia and hypoxemia are prevented by Ticlopidine, probably by modulating the complement activation.
该研究对每位患者连续进行4次血液透析（HD）治疗，其中2次使用铜仿膜（CU）（金宝120M），2次使用醋酸纤维素膜（CA）（科迪斯·陶氏3500）。在HD治疗前60分钟，给每位患者口服安慰剂或噻氯匹定（500毫克）。在HD开始前以及开始后15、30、60、120和240分钟测量白细胞和血小板计数、血清C3补体、动脉血氧分压（PO2）、二氧化碳分压（PCO2）和酸碱度（PH）。在两次安慰剂HD治疗的15分钟内，白细胞计数均显著下降，但CA膜组的白细胞计数显著低于CU膜组（p<0.005）。噻氯匹定可显著预防HD诱导的白细胞减少（p<0.01）。在安慰剂或噻氯匹定研究中，均观察到血小板计数有轻微变化。在CU安慰剂治疗的15分钟时，血清C3补体显著升高（p<0.05），且与同时出现的白细胞减少相关（p<0.01）。使用CU膜和CA膜进行HD治疗期间，动脉PO2分别下降了22%和13.5%，但噻氯匹定可使其维持在正常范围内。在所有HD治疗结束时，动脉PH升高至7.4，而PCO2仅出现轻微变化。我们得出以下结论：1）CA膜的耐受性优于CU膜；2）噻氯匹定可能通过调节补体激活来预防HD诱导的白细胞减少和低氧血症。
