血液透析膜生物相容性及在重症胰腺炎中的应用

摘要

背景：连续性血液净化可以清除细胞因子和炎症递质，维持内环境稳定，阻止重症胰腺炎患者多器官功能障碍综合征发生，已经成为重症胰腺炎患者中的主要治疗方法。血液透析技术从应用开始，学者就对透析膜材料及其理化生物特性进行了研究，并且相继研究出多种血液透析膜，以改善其生物相容性及机体外抗凝效果。目的：观察血液透析膜在重症胰腺炎疾病中的应用效果。方法：将体积分数5%的牛磺胆酸钠逆行胆胰管注射建立急性重症胰腺炎大鼠模型，建模后随机分2组，在血液透析过程中分别采用血仿膜和聚砜膜透析，每组5只，进行血液透析生化指标检测。结果与结论：①血液透析生化指标检测结果：与血仿膜组相比，聚砜膜组超滤系数、肌酐清除率、尿素氮清除率、磷清除率、循环血内皮细胞数量、血浆一氧化氮和非对称性二甲基精氨酸浓度显著降低(P <0.05)；聚砜膜组维生素B12清除率以及预充血量显著升高(P <0.05)。②结果证实，聚砜膜血液透析时生物相容性较好，在重症急性胰腺炎患者中能够维持其内环境稳定。%BACKGROUND: Continuous blood purification can remove cytokines and inflammatory mediators, maintain homeostasis and prevent the occurrence of multiple organ dysfunction syndrome in patients with severe pancreatitis, which has become the main therapy for severe pancreatitis. Since the hemodialysis technology began to be applied clinical y, the biological and physicochemical properties of hemodialysis membrane materials have been studied. A variety of hemodialysis membranes have been developed in order to improve the biocompatibility and anticoagulant effect in vitro. OBJECTIVE: To investigate the application effect of hemodialysis membranes on severe pancreatitis. METHODS: Ten Wistar rats were selected to make rat models of severe pancreatitis and then were randomized into two groups (n=5 per group): homophone membrane group and polysulfone membrane group. Hemodialysis- related biochemical parameters were detected in the two groups. RESULTS AND CONCLUSION: Compared with the homophone membrane, ultrafiltration coefficient, creatinine clearance, blood urea nitrogen clearance, phosphorus clearance, number of circulating endothelial cel s, and levels of plasma nitric oxide and asymmetric dimethylarginine were significantly lower in the polysulfone membrane group (P < 0.05). Vitamin B12 clearance and amount of pre-congestion increased significantly in the polysulfone membrane group as compared with the homophone membrane (P < 0.05). These findings indicate that the polysulfone membrane for hemodialysis has good biocompatibility, and keeps a stable environment in vivo for severe pancreatitis patients.