透析膜的生物相容性与血液透析患者细胞因子产生的研究

Study on biocompatibility of dialyzer and production of cytokine in patients with hemodialysis

目的：探讨透析膜的生物相容性与内毒素对细胞因子产生的影响。方法：选用 １５ 例维持性血液透析 患 者，分 别 选用 铜仿 膜（ Ｃｕ ）、血 仿膜 （ Ｈ Ｆ）透 析器， 观 察单 次 透析 过 程中 外 周血 单 个核 细 胞产 生 Ｉ Ｌ１β、 Ｔ Ｎ Ｆα的活性水平及基因表达，评估不同透析膜的生物相容性。结果： Ｃｕ 组 Ｉ Ｌ１β及 Ｔ Ｎ Ｆα的活性水平及基因表 达较透前及正常对照组显著升高 （ Ｐ＜ ０． ０５）， Ｈ Ｆ 组 Ｉ Ｌ１β及 Ｔ Ｎ Ｆα的活 性水平 及基因 表达较 透前 及正常对 照组无显著性差异（ Ｐ＞ ０．０５）。结论： Ｈ Ｆ 膜的生物相容性优于 Ｃｕ 膜；脂多糖（ Ｌ Ｐ Ｓ）与 Ｃｕ 膜有协同作用，故应 避免透析液的细菌污染。

The production of cytokines during HD is mainly influenced by membrane biocompatibility and endotoxin/LPS,therefore we judged the biocompatibility of different membranes from the active level and gene expression of cytokines produced by peripheral mononuclear cells(PBMC) during HD. 15 patients on CHD were randomized to groups with Cu、HF membranes respectively compared with 15 normal controls.Results of Cu group showed that the activated level and gene expression of IL 1β and TNFα significantly elevated as compared with pre and normal control(P<0.05).The activated level and gene expression of IL 1β and TNFα in HF group had no significant change as compared with pre and normal control(P>0.05).Our data suggested that HF membrane is one of the biocompatible membrane for HD,and that the coordination of both LPS and Cu membrane results in IL 1β、TNFα mRNA elevation,therefore endotoxin contimination of dialysate should be avoided.