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血流对β2-微球蛋白在AN69透析器膜上吸附的影响。

Influence of blood flow on adsorption of beta2-microglobulin onto AN69 dialyzer membrane.

作者信息

Kandus A, Malovrh M, Bren A F

机构信息

Department of Nephrology, University Medical Center, Ljubljana, Slovenia.

出版信息

Artif Organs. 1997 Aug;21(8):903-6. doi: 10.1111/j.1525-1594.1997.tb00249.x.

Abstract

Adsorption onto the dialyzer membrane is a contributing factor to the elimination of beta2-microglobulin (beta2M) from the sera of uremic patients. The purpose of this prospective study was to ascertain the influence of the blood flow rate on adsorption of beta2M onto the polyacrylonitrile (AN69) hollow-fiber dialyzer membrane in 8 patients during regular hemodialysis (HD). Blood first passed through a low-flux polysulfone dialyzer and then through an AN69 dialyzer, which was not in contact with the dialysis fluid. During the investigation period (first hour of the HD session), the blood flow rate was 100 ml/ min (first part of the study), 200 ml/min (second part of the study), and 300 ml/min (third part of the study). Ultrafiltration was not performed during the investigation period. At the start of the HD sessions, the serum concentration of beta2M in the afferent blood line did not differ significantly among the 3 parts of the study. Serum beta2M was measured in samples taken from the afferent and efferent blood lines of the AN69 dialyzer at 5, 10, 15, 30, 45, and 60 min. The serum beta2M concentration decreased significantly in blood that had passed through the AN69 dialyzer. This decrease, indicating membrane adsorption, was maximal during the first part and minimal during the third part of study. The decrease in the contact time between the blood and the AN69 could be the underlying cause. The calculated quantities of beta2M adsorbed onto the AN69 membrane (44.2 +/- 10.2, 43.2 +/- 12.1, and 42.6 +/- 17.3 mg) did not differ significantly among the 3 parts of the study. These results suggest that an increase in blood flow rate from 100 to 300 ml/min did not significantly affect the quantity of beta2M adsorbed onto the AN69 membrane.

摘要

吸附到透析器膜上是尿毒症患者血清中β2-微球蛋白(β2M)清除的一个促成因素。这项前瞻性研究的目的是确定8例患者在常规血液透析(HD)期间,血流速度对β2M吸附到聚丙烯腈(AN69)中空纤维透析器膜上的影响。血液首先通过一个低通量聚砜透析器,然后通过一个不与透析液接触的AN69透析器。在研究期间(HD疗程的第一小时),血流速度分别为100毫升/分钟(研究的第一部分)、200毫升/分钟(研究的第二部分)和300毫升/分钟(研究的第三部分)。研究期间不进行超滤。在HD疗程开始时,传入血路中β2M的血清浓度在研究的三个部分之间没有显著差异。在5、10、15、30、45和60分钟时,从AN69透析器的传入和传出血路中采集样本测量血清β2M。通过AN69透析器的血液中血清β2M浓度显著降低。这种降低表明膜吸附,在研究的第一部分最大,在第三部分最小。血液与AN69之间接触时间的减少可能是潜在原因。计算得出吸附到AN69膜上的β2M量(44.2±10.2、43.2±12.1和42.6±17.3毫克)在研究的三个部分之间没有显著差异。这些结果表明,血流速度从100毫升/分钟增加到300毫升/分钟对吸附到AN69膜上的β2M量没有显著影响。

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