Risler T, Braun N, Hanel K D, Kuhlmann U, Skroch D, Müller G A
Dept. of Medicine, University Hospital Tübingen, Germany.
Int J Artif Organs. 1994 Nov;17(11):581-4.
Hemodialysis is not an absolute prerequisite for the formation of beta 2-microglobulin amyloidosis, but it enhances the progression of this complication related to long-standing renal failure. Thus the clearance and turnover of beta 2-microglobulin seems to play a major role in this disease. In a prospective multicenter study the beta 2-microglobulin clearance was studied in 87 patients starting hemodialysis. Serum samples were taken prior to and after the first dialysis session and also before and after dialysis at 4, 6, 12, 16, 26 and 52 weeks. Patients were either treated by cuprophane or a polyacrylonitril membrane. At the start, the mean serum beta 2-microglobulin level was about 18 mg/L in patients treated with a cuprophane membrane, but the levels increased after hemodialysis and reached a plateau, which was always higher than in those treated with polyacrylonitril, which cleared beta 2-microglobulin from the serum. However, after 12 months the difference was no longer significant. Thus beta 2-microglobulin excretion during dialysis differs between the two membranes, but seems to lose its significance for the beta 2-microglobulin serum level in chronic hemodialysis treatment.
血液透析并非β2-微球蛋白淀粉样变形成的绝对必要条件，但它会加速这种与长期肾衰竭相关并发症的进展。因此，β2-微球蛋白的清除和周转似乎在这种疾病中起主要作用。在一项前瞻性多中心研究中，对87例开始进行血液透析的患者的β2-微球蛋白清除情况进行了研究。在首次透析治疗前后以及在第4、6、12、16、26和52周透析前后采集血清样本。患者分别接受铜仿膜或聚丙烯腈膜治疗。开始时，使用铜仿膜治疗的患者血清β2-微球蛋白平均水平约为18mg/L，但血液透析后水平升高并达到平台期，该平台期始终高于接受聚丙烯腈膜治疗的患者，后者能从血清中清除β2-微球蛋白。然而，12个月后差异不再显著。因此，两种膜在透析过程中β2-微球蛋白的排泄情况不同，但在慢性血液透析治疗中，这似乎对β2-微球蛋白血清水平不再具有重要意义。
