Wehle B, Bergstrom J, Kishimoto T, Lantz B, Levin N, Klinkmann H
Department of Renal Medicine, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
Nephrol Dial Transplant. 1993;8 Suppl 2:20-4. doi: 10.1093/ndt/8.supp2.20.
Plasma beta 2-M was measured by radioimmunoassay in samples obtained before and after dialysis with seven different dialysers, tested according to the protocol of the International Cooperative Biocompatibility Study (ICBS). Plasma beta 2-M was corrected for contraction of its distribution volume, which was assumed to be equal to the extracellular fluid volume. The uncorrected plasma beta 2-M concentration increased with all conventional dialysers, including the G10-3N, (cuprammonium cellulose plate), G120 M (cuprammonium cellulose hollow fibre), CD 4000 (cellulose acetate) and T 150 (polymethylmethacrylate). However, no significant differences were found between the predialysis and the corrected postdialysis plasma beta 2-M concentrations with these conventional dialysers, and thus no evidence of net generation or release of beta 2-M was found in this study. With high-permeability membranes, the corrected postdialysis beta 2-M values were decreased by 27.1% with the Duo-Flux Artificial Kidney, 53.5% with F 60, and 34.6% with Filtral, indicating that dialysers with these membranes eliminate plasma beta 2-M to a certain extent. The complex of granulocyte elastase with alpha 1-antiproteinase in plasma was also measured in samples from the arterial blood line collected before, and after 30 and 120 min of dialysis with each of the seven dialysers in this study. All dialysers elicited an increase in the mean plasma elastase concentrations which was more than twice as high with cuprammonium cellulose plate than with all of the others. The change of elastase at 120 min of dialysis varied considerably with each dialyser and was statistically significant with all except CD 4000, F 60, and Filtral.(ABSTRACT TRUNCATED AT 250 WORDS)
采用放射免疫分析法,对使用七种不同透析器透析前后采集的样本中的血浆β2-微球蛋白(beta 2-M)进行了测量,这些透析器是按照国际生物相容性合作研究(ICBS)的方案进行测试的。血浆β2-微球蛋白的浓度根据其分布容积的收缩情况进行了校正,假定分布容积等于细胞外液容积。所有传统透析器,包括G10-3N(铜氨纤维素平板)、G120 M(铜氨纤维素中空纤维)、CD 4000(醋酸纤维素)和T 150(聚甲基丙烯酸甲酯),透析后未校正的血浆β2-微球蛋白浓度均升高。然而,使用这些传统透析器时,透析前和校正后的透析后血浆β2-微球蛋白浓度之间未发现显著差异,因此本研究中未发现β2-微球蛋白净生成或释放的证据。对于高通透性膜,使用Duo-Flux人工肾时,校正后的透析后β2-微球蛋白值降低了27.1%,使用F 60时降低了53.5%,使用Filtral时降低了34.6%,这表明使用这些膜的透析器在一定程度上可清除血浆β2-微球蛋白。本研究还对使用七种透析器中的每一种进行透析前、透析30分钟和120分钟后,从动脉血路采集的样本中的血浆粒细胞弹性蛋白酶与α1-抗蛋白酶复合物进行了测量。所有透析器均导致血浆弹性蛋白酶平均浓度升高,其中铜氨纤维素平板引起的升高幅度是其他所有透析器的两倍多。透析120分钟时弹性蛋白酶的变化因透析器不同而有很大差异,除CD 4000、F 60和Filtral外,其他透析器的变化均具有统计学意义。(摘要截选至250字)