血液透析中分子清除分数与透析充分性的理论和临床研究

Clinical research and theory of mid-molecular clearance and dialysis sufficiency in bemodialysis

利用房室模型理论对尿毒症血液透析疗法中溶质在体液，即细胞内－组织间液－血液之间的传质过程进行了研究。采用摄动解的方法求出溶质在细胞与细胞间液之间的传质系数＝０．４８９±０．０３４，溶质在组织间液与血液之间的传质系数＝１５．７９０±０．６３０．结果提示：溶质在体液中的传质阻力与溶质的分子量成正比，与溶质的传质系数成反比。临床研究结果表明，中分子β２－微球蛋白透析周清除分数应＞４０％，它可以作为中分子清除充分性的评价指标，它与ＫＴ／Ｖ结合使用可以使得对透析充分性的评价更加完整。

In the theory of compartment,the solute in uremia blood transmits in body fluid,which include in-tracellular fluid, interstitial fluid and blood. The transmission process was studied The mass transmission coeffi-cient was calculated according to perturbation solution,the coefficient between intracellular and interstitial fluid is0.489±0.034,and that between interstitial and blood is 15.790±0.630.The result showed that the mass trans-mission resistance is direct proportional with the molecular of solute,and is inverse proportional with the masstransmission coefficient.It was suggested that the week clearance of β2-microglobulin( mid-molecular)should bemore than 40%,it can be a index to evaluate dialysis sufficiency,and it will be more perfect to evaluate dialysissufficiency with β2- microglobulin and KT/V