Docci D, Turci F, Del Vecchio C, Bilancioni R, Cenciotti L, Pretolani E
Int J Artif Organs. 1984 Nov;7(6):337-40.
To evaluate the relative contribution that dialyzer membrane composition and geometry make to hemodialysis-associated platelet loss, the effect of a single dialysis with three different types of dialyzers on platelet count was examined on a cross-over basis in 19 uremic patients on maintenance hemodialysis. Also, the plasma levels of antithrombin-iii before and after dialysis were measured, but no significant variations were found regardless of which dialyzer was in use. Our patients suffered significant platelet loss during cuprophan dialysis, but not polyacrylonitrile dialysis. More than 99% of initial circulating platelets were recovered at the end of polyacrylonitrile dialysis, whereas cuprophan dialysis did leave a significantly lower percentage of circulating platelets (p less than 0.05). The internal comparison of results obtained with the two cuprophan dialyzers used shows no difference as to the dialyzer geometry (flat plate or hollow fiber). This indicates that the membrane composition is the major factor influencing hemodialysis-associated platelet loss. We suggest that patients with low platelet count and/or with risk of bleeding may benefit from polyacrylonitrile dialysis.
为评估透析器膜的组成和几何形状对血液透析相关血小板损失的相对影响，在19例维持性血液透析的尿毒症患者中，采用交叉试验的方法，研究了三种不同类型的透析器单次透析对血小板计数的影响。同时，测定了透析前后抗凝血酶III的血浆水平，结果发现，无论使用哪种透析器，抗凝血酶III水平均无显著变化。我们的患者在铜仿膜透析过程中出现了显著的血小板损失，但在聚丙烯腈膜透析过程中则没有。在聚丙烯腈膜透析结束时，超过99%的初始循环血小板得以恢复，而铜仿膜透析后循环血小板的比例则显著降低（p<0.05）。对所使用的两种铜仿膜透析器的结果进行内部比较发现，透析器的几何形状（平板型或中空纤维型）对结果没有影响。这表明膜的组成是影响血液透析相关血小板损失的主要因素。我们建议，血小板计数低和/或有出血风险的患者可能会从聚丙烯腈膜透析中获益。
