Baumgartner-Parzer S M, Seyfert U T, Mannhalter C
Department of Internal Medicine III, University of Vienna, Austria.
Kidney Int. 1995 Apr;47(4):1115-20. doi: 10.1038/ki.1995.159.
In this study data obtained in an in vitro hemodialysis model are related to various parameters measured in patients' plasma during hemodialysis in a clinical crossover study. In vitro, blood from healthy volunteers was dialyzed under standardized conditions using the capillaries Fresenius MTS C (Cuprophane) and Hospal AN 69 (Polyacrylonitrile). Following dialysis, surface bound proteins were eluted with saline, 1 M Tris and 2% SDS, and analyzed by immunoblotting. Depending on the capillary, different protein patterns could be identified in the eluates. Intact forms of adhesion proteins were predominantly (fibrinogen) or exclusively (vitronectin) found in PA eluates. In contrast, low molecular weight products of fibrinogen as well as high molecular weight components containing antithrombin III (AT III) were present in CP eluates. Their presence may reflect fibrinolytic and procoagulatory activity during dialysis with CP capillaries. A microscopic investigation of CP membranes demonstrated fibrin lined platelet conglomerates. In the plasmas of patients dialyzed with CP capillaries high D-Dimer concentrations were found. We also noticed that during dialysis with PA membranes less heparin was consumed than during dialysis with CP membranes. Our study showed a good correlation of the observations in the vitro system and the measurements in patient samples.
在本研究中，体外血液透析模型所获得的数据与一项临床交叉研究中患者血液透析期间血浆中测量的各种参数相关。在体外，使用费森尤斯MTS C（铜仿膜）和霍斯帕尔AN 69（聚丙烯腈）毛细血管，在标准化条件下对健康志愿者的血液进行透析。透析后，用生理盐水、1M Tris和2% SDS洗脱表面结合蛋白，并通过免疫印迹法进行分析。根据毛细血管的不同，在洗脱液中可鉴定出不同的蛋白质模式。在聚丙烯腈洗脱液中主要（纤维蛋白原）或仅（玻连蛋白）发现完整形式的黏附蛋白。相比之下，铜仿膜洗脱液中存在纤维蛋白原的低分子量产物以及含有抗凝血酶III（AT III）的高分子量成分。它们的存在可能反映了使用铜仿膜毛细血管透析期间的纤溶和促凝血活性。对铜仿膜的显微镜检查显示有纤维蛋白内衬的血小板聚集体。在用铜仿膜毛细血管透析的患者血浆中发现了高D - 二聚体浓度。我们还注意到，与使用铜仿膜透析相比，使用聚丙烯腈膜透析期间消耗的肝素较少。我们的研究表明体外系统中的观察结果与患者样本中的测量结果具有良好的相关性。
