Ward R A, McLeish K R
Department of Medicine, School of Medicine, University of Louisville, Kentucky 40292, USA.
Artif Organs. 1995 Aug;19(8):801-7. doi: 10.1111/j.1525-1594.1995.tb02431.x.
Hemodialysis with cellulose membranes causes a complement-mediated neutropenia. Changes in neutrophil function have also been reported; however, it is unclear if these changes indicate a direct effect of the membrane on neutrophils or if they are a consequence of the neutropenia. We tested the hypothesis that neutrophil oxidative burst activity is enhanced during dialysis with cellulose membranes. Resting and Staphylococcus aureus-stimulated H2O2 production were determined predialysis and in blood entering and leaving the dialyzer during the first 30 min of dialysis and in blood leaving the membrane module in a single-pass on-line model of hemodialysis. Resting H2O2 production increased slightly but significantly during the first 30 min of dialysis. Transit of neutrophils through the dialyzer caused a marked increase in stimulated H2O2 production, indicating priming of the oxidative burst. However, priming was limited to the first 5 min of dialysis before the onset of neutropenia. In contrast, stimulation and priming of H2O2 production persisted throughout 30 min of single-pass on-line perfusion. These results indicate that cellulose membranes both stimulate and prime neutrophil oxidative burst activity but that these effects are partially obscured by neutropenia.
使用纤维素膜进行血液透析会导致补体介导的中性粒细胞减少。也有报道称中性粒细胞功能发生了变化；然而，尚不清楚这些变化是表明膜对中性粒细胞有直接影响，还是中性粒细胞减少的结果。我们检验了这样一个假设，即在使用纤维素膜透析期间中性粒细胞氧化爆发活性会增强。在血液透析的单通道在线模型中，测定了透析前以及透析开始后30分钟内进入和离开透析器的血液以及离开膜组件的血液中静息和金黄色葡萄球菌刺激后的过氧化氢（H₂O₂）生成量。在透析的前30分钟内，静息H₂O₂生成量略有增加但显著增加。中性粒细胞通过透析器导致刺激后的H₂O₂生成量显著增加，表明氧化爆发被启动。然而，启动仅限于中性粒细胞减少症出现前的透析前5分钟。相比之下，在单通道在线灌注的30分钟内，H₂O₂生成的刺激和启动持续存在。这些结果表明，纤维素膜既刺激又启动中性粒细胞氧化爆发活性，但这些作用部分被中性粒细胞减少症所掩盖。
