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[配对滤过透析——该方法有效性评估]

[Paired filtration dialysis--evaluation of effectiveness of the method].

作者信息

Eiselt J, Racek J, Opatrný K

机构信息

I. interní klinika LF UK a FN, Plzen.

出版信息

Vnitr Lek. 1998 Jun;44(6):320-5.

PMID:9820053
Abstract

Paired filtration dialysis (PFD) is a haemodiafiltration method which uses in a major way the convection as well as the diffusion principle of blood clearance. It is the only method replacing renal function where blood filtration is separated from diffusion. The objective of the study is to make the medical community familiar with this method and to assess the effectiveness of PFD when two types of haemodiafilters are used. The effectiveness of PFD is also compared with haemodialysis where a highly permeable haemofilter is used (high-flux haemodialysis, HFHD) with a medium-size area. A group of 8 dialyzed patients was treated after weekly intervals by PFD in two set-ups: 1. PFD with a haemodiafilter SG3 (high-flux polysulphon haemofilter and a low-flux haemophan dialyzer, area 0.55 m2 and 1.36 m2). 2. PFD with haemodiafilter SG30 (high-flux polysulphon haemofilter and low-flux polysulphon dialyzer, area 0.55 m2 and 1.36 m2). The author used also HFHD with a polyacrylonitrile membrane AN 69 (Filtral 12, area 1.3 m2). The index of the dialyzation dose Kt/V was higher in PFD, similarly as the clearance of creatinine, urea, phosphates and uric acid. Beta-2-microglobulin was investigated as a representative of medium-sized molecular substances. Beta-2-microglobulin was eliminated in HFHD and PFD, HFHD being most effective. The selected variants of PFD replace effectively the excretory renal function. The effectiveness of PFD is in particular due to the large total area of the haemodiafilter. According to the authors the standard length of the procedure for a patient with a mean height at a rate of 300 ml/min. is 4 hours. PFD eliminates also beta-2-microglobulin similarly (SG3) or less (SG30) than HFHD with membrane AN 69 with a medium-sized area.

摘要

配对过滤透析(PFD)是一种血液透析滤过方法,它主要利用对流以及血液清除的扩散原理。它是唯一一种将血液过滤与扩散分离来替代肾功能的方法。该研究的目的是让医学界熟悉这种方法,并评估使用两种类型血液透析滤过器时PFD的有效性。还将PFD的有效性与使用中等面积的高通透性血液滤过器进行血液透析(高通量血液透析,HFHD)进行比较。一组8名接受透析的患者每隔一周接受两次PFD治疗:1. 使用血液透析滤过器SG3进行PFD(高通量聚砜血液滤过器和低通量血仿透析器,面积分别为0.55平方米和1.36平方米)。2. 使用血液透析滤过器SG30进行PFD(高通量聚砜血液滤过器和低通量聚砜透析器,面积分别为0.55平方米和1.36平方米)。作者还使用了带有聚丙烯腈膜AN 69(Filtral 12,面积1.3平方米)的HFHD。透析剂量Kt/V指数在PFD中更高,肌酐、尿素、磷酸盐和尿酸的清除率也是如此。β2-微球蛋白作为中等大小分子物质的代表进行了研究。β2-微球蛋白在HFHD和PFD中均可清除,HFHD最为有效。所选的PFD变体有效地替代了肾脏的排泄功能。PFD的有效性尤其归因于血液透析滤过器的总面积较大。据作者称,对于平均身高的患者,以300毫升/分钟的速率进行该操作的标准时长为4小时。PFD清除β2-微球蛋白的效果与中等面积的膜AN 69的HFHD相似(SG3)或更低(SG30)。

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