Asanuma Y, Malchesky P, Smith J, Zawicki I, Werynski A, Carey W, Ferguson D, Hermann R, Kayashima K, Nosé Y
Trans Am Soc Artif Intern Organs. 1981;27:416-22.
Blood cellular elements and plasma protein losses are minimal for membrane plasmapheresis with on-line sorbent detoxification. Frequent (6/sk), chronic (3 mos), and long-term (8 hr) perfusions are possible for patients studied. It is recommended in deficiency states involving low protein, hypocoagulability or potential hormonal imbalances that aggressive medical management be applied. With regard to system performance, plasma filtration properties improved by the application of the closed plasma circuit and membranes with superior sieving and filtration properties. The effect of plasma solutes on filtration properties has been noted. In PBC patients the influence of total cholesterol concentration is particularly striking. Significant reduction of FFA and improvement of PMR were achieved in combination with bilirubin removal in liver failure patients, while bile acids (cholyglycine) levels were significantly reduced in 3 of PBC patients who expressed a subjective improvement of about 90% following 3 consecutive treatments. Four of 5 liver failure patients showed improved mental status with one patient surviving.
对于采用在线吸附剂解毒的膜血浆置换术，血细胞成分和血浆蛋白的损失极小。对于所研究的患者，可以进行频繁（每周6次）、长期（3个月）和长时间（8小时）的灌注。对于存在低蛋白、低凝性或潜在激素失衡的缺乏状态，建议采用积极的医学管理。关于系统性能，通过应用封闭血浆回路和具有卓越筛分和过滤特性的膜，血浆过滤性能得到改善。已经注意到血浆溶质对过滤性能的影响。在原发性胆汁性胆管炎（PBC）患者中，总胆固醇浓度的影响尤为显著。在肝功能衰竭患者中，结合胆红素清除实现了游离脂肪酸（FFA）的显著降低和最大反应电位（PMR）的改善，而在连续3次治疗后主观改善约90%的3例PBC患者中，胆汁酸（甘氨胆酸）水平显著降低。5例肝功能衰竭患者中有4例精神状态改善，1例存活。
