Topley N, Coles G A, Williams J D
Institute of Nephrology, University of Wales College of Medicine, Cardiff Royal Infirmary, United Kingdom.
Perit Dial Int. 1994;14 Suppl 3:S21-8.
This review outlines the problems involved in assessing the biocompatibility of PD fluids. It has summarized the data available from conventional in vitro studies and highlights many of the inadequacies of this approach. In vivo data are lacking both on host defense and on the clinical effect of changing conventional PD fluids for a more "ideal" formulation. The best parameters for assessing biocompatibility need to be defined. Alternative formulation of fluids must be aimed towards (1) a system that interferes minimally with host defense, and (2) a system that maintains the integrity of the peritoneal membrane for ultrafiltration and clearance. Cell culture studies should be designed to model the in vivo situation. Ex vivo studies (cells exposed within the peritoneal cavity) should be used to support in vivo findings. Finally, in vitro results must be related to clinical significance, and changes in fluid composition should be followed by improvements in clinical outcome.
本综述概述了评估腹膜透析液生物相容性所涉及的问题。它总结了传统体外研究可得的数据，并突出了这种方法的许多不足之处。在宿主防御以及将传统腹膜透析液换成更“理想”配方的临床效果方面，体内数据均很缺乏。需要确定评估生物相容性的最佳参数。透析液的替代配方必须针对：（1）对宿主防御干扰最小的系统，以及（2）维持腹膜完整性以进行超滤和清除的系统。细胞培养研究的设计应模拟体内情况。离体研究（细胞在腹腔内暴露）应用于支持体内研究结果。最后，体外结果必须与临床意义相关，并且透析液成分的改变应伴随着临床结局的改善。
