中国血液净化

中国血液净化

• 基础研究 • 上一篇    下一篇

三醋酸纤维素膜及低/高通量聚砜膜透析器对内毒素的截留能力研究

陈  欢    刘  昕      陈  玮     燕  宇    王  梅   

  1. 北京大学人民医院肾内科, 卫生部北京医院肾内科
  • 收稿日期:2012-06-27 出版日期:2012-08-12 发布日期:2012-12-24

The in vitro study on endotoxin transfer across dialyzers of different dialysis membrane and flux

CHEN Huan,   LIU Xin,  CHEN Wei,  YAN Yu , WANG Mei   

  • Received:2012-06-27 Online:2012-08-12 Published:2012-12-24
  • Contact: 王梅

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摘要： 【摘要】目的  通过体外实验了解不同膜材料及通量的透析器对内毒素的截留能力。 方法依透析器类型分三醋酸纤维素膜/低通量(130G)、聚砜膜/低通量(F6hps)、聚砜膜/高通量(F60S)3组。体外模拟血液透析4h，血液侧为无菌生理盐水500ml，流速200ml/min。透析液侧为无菌生理盐水1000ml，分别以浓度为2EU/ml、10EU/ml、20EU/ml的纯化内毒素污染透析液，透析液流速200ml/min。采用鲎试剂动态比浊法检测透析液和血液侧样本的内毒素浓度，并对3组透析液中内毒素下降程度进行比较。 结果①以含内毒素≤20EU/ml的透析液透析4h，3组透析器血液侧样本的内毒素检测均为阴性。透析液内毒素水平均随时间延长呈现下降趋势。②比较透析前后透析液中内毒素下降程度，显示3种透析器透析液内毒素的下降排序为F60S＞F6hps＞130G。其中130G与F60S2组间比较差异有统计学意义(P=0.036)。 结论不论是三醋酸纤维素膜低通量透析器还是低或高通量聚砜膜透析器对透析液内毒素浓度≤20EU/ml时都有很好的阻隔能力。与三醋酸膜透析器比较，高通量聚砜膜透析器对内毒素的吸附能力更强。聚砜膜高与通量透析器之间无显著差异。

关键词: 内毒素, 三醋酸纤维膜, 聚砜膜, 通量

Abstract: 【Abstract】Objective To assess the transfer of endotoxin across cellulose triacetate (CTA, low-flux) and polysulfone (high- or low-flux) membranes. Methods Three groups based on the dialyzer of different membrane and flux were used in this study. Experiments were carried out in saline-saline model. The dialysate was contaminated with purified lipopolysaccharide (LPS) (2EU/ml, 10EU/ml or 20EU/ml). Samples were drawn from blood side and dialysate outflow every 1 hour during dialysis process. Endotoxin level was detected by kinetic turbidimetric LAL method. We compared the decrease degree of endotoxin in dialysate among groups.  Results All blood side samples were LAL negative after 4-hour dialysis. Endotoxin concentration in dialysate decreased along with dialysis time, and F60S was significant faster than 130G in decrease degree of endotoxin in dialysate (59.99±13.68% vs. 83.37±9.14%, P=0.036).  Conclusion Within the limit of 20EU/ml in dialysate, no transfer of endotoxin was observed across high-/low- flux polysulfone and low-flux CTA dialyzers. Polysulfone high-flux dialyser has an advantage of endotoxin absorbility more than CTA low-flux dialyser. No significant difference was observed between high- and low-flux polysulfone dialysers.

Key words: Endotoxin, Cellulose triacetate membrane, Polysulfone membrane, Flux