透析膜的生物相容性：慢性补体激活的影响。

Biocompatibility of dialysis membranes: effects of chronic complement activation.

作者信息

Hakim R M, Fearon D T, Lazarus J M

出版信息

Kidney Int. 1984 Aug;26(2):194-200. doi: 10.1038/ki.1984.155.

DOI:10.1038/ki.1984.155

Abstract

The ability of three dialysis membranes (cuprophane, cellulose acetate, and polymethylmethacrylate) to activate complement was studied prospectively in ten chronic dialysis patients using new and reused membranes. Patients were dialyzed for 1 month with each type of membrane. New cuprophane membranes caused the most intense activation, while polymethylmethacrylate (PMMA) surfaces caused the least degree of complement activation. Reuse decreases the capacity of the cuprophane membrane to activate complement but does not significantly alter the capacity of cellulose acetate membranes. The extent of complement activation paralleled the ability of these membranes to induce neutropenia. Recurrent dialysis with new cuprophane and cellulose acetate membranes leads to a decrease in pre-dialysis and "rebound leukocytosis" neutrophil count, as well as a more intense activation of complement and an enhanced endogenous clearance of products of complement activation. The clinical sequelae of recurrent complement activation are discussed.

摘要

使用新的和重复使用的透析膜，对三种透析膜（铜仿膜、醋酸纤维素膜和聚甲基丙烯酸甲酯膜）激活补体的能力进行了前瞻性研究，研究对象为10名慢性透析患者。每种类型的膜对患者进行1个月的透析。新的铜仿膜引起的激活最为强烈，而聚甲基丙烯酸甲酯（PMMA）表面引起的补体激活程度最低。重复使用会降低铜仿膜激活补体的能力，但不会显著改变醋酸纤维素膜的激活能力。补体激活的程度与这些膜诱导中性粒细胞减少的能力平行。使用新的铜仿膜和醋酸纤维素膜进行反复透析会导致透析前和“反弹性白细胞增多”时中性粒细胞计数降低，以及补体激活更为强烈和补体激活产物的内源性清除增强。本文讨论了反复补体激活的临床后果。