中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (01): 18-22.doi: 10.3969/j.issn.1671-4091.2025.01.003

• 临床研究 • 上一篇    下一篇

密闭式回浆在双重血浆分子吸附治疗中的应用效果评价：一项前瞻性随机对照研究

王蓓蓓   周圣瑜   赵 媛   林 丽   孙献坤   王 芳   张 凌   陈志文   

  1. 610041 成都，1四川大学华西医院肾脏内科
    610213 成都，2四川大学华西天府医院肾内科
  • 收稿日期:2024-05-07 修回日期:2024-10-28 出版日期:2025-01-12 发布日期:2025-01-12
  • 通讯作者: 陈志文 E-mail:kiyuhot@163.com

Application effect evaluation of closed plasma return in double plasma molecular adsorption system (DPMAS) Treatment: A prospective randomized controlled study

WANG Bei-bei, ZHOU Sheng-yu, ZHAO Yuan,LIN Li, SUN Xian-kun, WANG Fang, ZHANG Ling，CHEN Zhi-wen   

  1. Department of Nephrology,West China Hospital of Sichuan University, Chengdu 610041,  China; 2Department of Nephrology, West China Tianfu Hospital, Sichuan University，Chengdu 610213, China.
  • Received:2024-05-07 Revised:2024-10-28 Online:2025-01-12 Published:2025-01-12
  • Contact: 610041 成都，1四川大学华西医院肾脏内科 E-mail:kiyuhot@163.com

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摘要： 目的 评估密闭式回浆在双重血浆分子吸附系统(double plasma molecular absorption system，DPMAS)治疗中的应用效果。 方法 选取2021年5月─2023年2月在四川大学华西医院行DPMAS治疗的患者60例。将患者随机分为不回浆组、密闭式回浆400 ml组和密闭式回浆600 ml组，每组患者20例。比较3组在DPMAS治疗结束回浆后白蛋白的残留量、密闭式回浆组在回浆前后血中胆红素的变化。 结果  DPMAS治疗结束回浆后，3组患者在胆红素吸附器、血液灌流器和体外循环回路管部位的剩余白蛋白比较有统计学差异，平均白蛋白残留量比较有统计学差异(H=52.465， P＜0.001)。密闭式回浆400 ml组，密闭式回浆600 ml组在回浆前和回浆后血中胆红素差异无统计学意义(t=-0.461、-0.513，P=0.647、0.611)。 结论 密闭式回浆不仅可以减少患者的白蛋白丢失，而且不会增加胆红素脱落的风险。

关键词: 双重血浆分子吸附系统, 密闭式回浆, 白蛋白, 胆红素

Abstract: Objective  To evaluate the application effect of closed plasma reinfusion in the treatment of patients with double plasma molecular absorption system (DPMAS).   Methods  A total of 60 patients who underwent DPMAS treatment in our hospital from May 2021 to February 2023 were selected and randomly divided into three groups: non-reinfusion group, closed plasma reinfusion 400 ml group, and closed plasma reinfusion 600 ml group, with 20 patients in each group. The loss of albumin after the completion of DPMAS treatment and the change in bilirubin levels in the blood before and after plasma reinfusion in the closed plasma reinfusion groups were compared.  Results  After DPMAS treatment and reinfusion, the remaining albumin levels in different locations of the three groups were significantly different (bilirubin adsorber: 11.9(10.4, 13.0)g vs. 1.2 (1.0, 1.5)g vs. 0.8(0.6, 0.9)g, H=49.266, P<0.001). hemoperfusion device: 11.9 (10.4, 13.0) g vs. 4.0 (3.7, 5.2) g vs. 1.3(1.1, 2.0)g, H=52.477, P<0.001). extracorporeal circuit: 11.9(10.4,13.0)g vs. 9.0(7.9,10.0)g vs. 3.2(2.2, 3.8)g, H=46.787, P<0.001). The average albumin loss was also significantly different [11.9(10.4, 13.0)g vs. 4.7(4.3, 5.3)g vs. 1.8(1.4, 2.0)g, H=52.465, P<0.001]. In the closed plasma reinfusion groups (400 ml and 600 ml), no statistically significant difference was observed in bilirubin levels before [(236.21±98.31) vs. (224.07±64.63)mmol/L, t=-0.461, P=0.647] and after reinfusion [(233.83±99.98) vs. (220.04±66.67)mmol/L, t=-0.513, P=0.611].  Conclusion  Closed plasma reinfusion can not only reduce the loss of albumin in patients but also does not increase the risk of bilirubin shedding.

Key words: Double plasma molecular adsorption system (DPMAS), Closed plasma return, albumin, bilirubin

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