不同类型透析膜对维持性血液透析患者血清C-反应蛋白水平变化的影响

Effects of different dialyzer membranes on serum levels of C-reactive piofein in patients undergoing maintenance hemodialysis

目的 观察尿毒症维持性血液透析患者血清C -反应蛋白 (Creactiveprotein ,CRP)水平的变化以及不同类型透析膜初次与复用对其的影响 ,从机体免疫功能的角度对透析膜的生物相容性进行评价。方法 采用免疫速率散射比浊法测定尿毒症维持性血液透析患者初用和复用醋酸纤维素膜 (CA)、血仿膜 (HE)和聚砜膜 (PS)透析器进行透析时患者血清CRP水平的变化 ,并加以比较。同时检测健康查体和尿毒症非透析患者的CRP水平作为对照。结果 尿毒症血液透析治疗患者透析前及尿毒症非透析患者血清CRP水平均较健康查体对照组显著增高。尿毒症患者透析开始后 4 .5h血清CRP水平与透析前相比明显升高 (P <0 .0 5 ) ,HD后 1 5h后差异更为明显。使用醋酸纤维素膜 (CA)透析器患者的血清CRP水平更明显高于使用血仿膜 (HE)和聚砜膜 (PS)透析器的患者 (P <0 .0 5 )。结论 血液透析可导致尿毒症血透患者血清CRP水平的增高 ,这种变化与透析膜的生物相容性有关 ,而透析器复用可在一定程度上减轻这种变化。

Objective To investigate the changes of the serum C-reacti ve protein (CRP)levels during maintenance hemodialysis,there by assessing the bi ocompatibility of different dialyzer membranes.Methods In the first use and reuse of different dialyzer membranes (cellulose acet ate,Hemophan,Polysulfone),the levels of serum CRP were determined in uremic pa tients undergoing hemodialysis,uremic patients not undergoing hemodialysis,and h ealthy controls.Results Before dialysis,the levels of CRP in chronic renal failure(CRF) patients were significantly higher than that in t he healthy control group.Compared with before dialysis,the levels of CRP in pati ents under going maintenance hemodialysis (MHD)increased significantly at 4 h an d 30 minutes after initiaion of hemodialysis(P<0.05),especially at 6 hour a fter dialysis.The CRP level in patients using cellulose acetate membranes was si gnificantly higher than those using Hemophan and Poly sulfone membranes (P< 0.05)。The difference in effects on levels of CRP Aetween the different of dialy zer membranes was reduced after using the dialyzer membranes repeatedly. Conclusion Hemodialysis be leads to increase in serum CRP levels in uremic patients.This changes are associated with the biocompatibility of dialyze r membranes, and reuse of dialyzer may ameliorate membrane biocompatibility.