中国血液净化

›› 2009, Vol. 8 ›› Issue (7): 386-389.

• 基础研究 • 上一篇    下一篇

REXEEDTM15UC透析器在线血液透析滤过中白蛋白丢失的实验研究

戴慧莉 王咏梅 张伟明 吴青伟 郦 忆 王 杰 严玉澄 钱家麒   

  1. 上海交通大学医学院附属仁济医院肾脏科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-01-01 发布日期:2009-01-01

Experiment study on albumin loss during on-line hemodiafiltration with the new polysulfone high-flux membrane REXEED-15UC dialyzer

DAI Hui-li, WANG Yong-mei, ZHANG Wei-ming, WU Qing-wei, LI Yi, WANG Jie, YAN Yu-cheng, QIAN Jia-qi   

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-01-01 Published:2009-01-01

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摘要：

【摘要】目的 评价REXEEDTM-15UC透析器在在线血液透析滤过(on-line HDF)过程中白蛋白丢失特性。方法 建立等容on-line HDF体外循环装置，采用新鲜牛血3～4L，Hct为(31±2)%。使用REXEEDTM-15UC透析器，并以HF-80S高通量透析器为对照；Qb=350mL/min，Qd=800ml/min，按置换液输入模式分为后稀释组(Quf=40ml/min,60ml/min)和前稀释组(Quf=80ml/min,120mL/min)每组重复3次，每次240min。实验开始后0、1、2、4、6、8、10、20、30、40、50、60、120、180、240min，采集透析滤过废液5ml，用酶联免疫法测定白蛋白浓度，根据曲线下面积计算每次HDF过程中丢失白蛋白总量。结果 REXEED-15UC 和HF-80S透析器在4h前稀释和后稀释on-line HDF过程中，白蛋白丢失量均小于 1.0g(0.261g～0.963g)。在后稀释模式不同置换液剂量(Qf=40ml/min和60mlS/min)时，白蛋白丢失量分别为：(0.261±0.189)g和(0.496±0.338)g (P＞0.05)，(0.300±0.030)g 和(0.488±0.264)g (P＞0.05)。在前稀释模式不同置换液剂量(Qf=80ml/min和120ml/min)时，白蛋白丢失量分别为： (0.788±0.406)g和(0.469±0.325)g(P＞0.05)，(0.614±0.284)g和(0.963±0.701)g(P＞0.05)。各组白蛋白丢失峰值出现在HDF开始时至开始后10min。结论 REXEEDTM 15UC在on-line HDF过程中，白蛋白丢失量小，在临床可接受范围内。

关键词: 血液透析滤过, 白蛋白丢失, 高通量透析器

Abstract:

【Abstract】 Objectives To evaluate albumin loss during on-line hemodiafiltration (HDF) by using the new polysulfone high-flux membrane REXEED-15UC dialyzer. Methods An in vitro isovolemic online HDF model was established using bovine blood. REXEED-15UC dialyzer was used, and its effect was compared with that using HF-80S high-flux dialyzer. The experiment was divided into two groups: post-dilution HDF group (Quf=40mL/min and 60mL/min; N=3), and pre-dilution HDF group (Quf=80mL/min and 120mL/min; N=3). HDFwas lasted for 240 minutes and repeated for 3 times. Hemodiafiltrate fluid was taken out at different points (after 0, 1, 2, 4, 6, 8, 10, 20, 30, 40, 50, 60, 120, 180, and 240 minutes from the beginning of the experiment) during a single on-line HDF session. Albumin in hemodiafiltrate was measured by ELISA, and the total albumin loss in a HDF session was calculated using the area under the curve from the HDF using the REXEED-15UC dialyzer and HF-80S dialyzer. Results In the 2 groups using REXEED-15UC dialyzer or HF-80S dialyzer, albumin loss was less than 1.0g (0.261- 0.963g) in a single on-line HDF session. No statistical significance in albumin loss was found between the 2 doses used for post-dilution HDF group and pre-dilution HDF group in a single HDF session. In the two groups, the peak of albumin loss appeared in the first 10 minutes from beginning of the experiment. Conclusions REXEED-15UC dialyzer shows lower and clinically acceptable albumin loss in an on-line HDF session.

Key words: Albumin loss, High-flux dialyzer

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