不同种类透析膜对血浆补体终末复合物浓度的影响

Effects of different kinds of hemodialysis membrane on plasma concentration of SC5b-9

目的 了解不同种类透析膜对补体系统激活的影响。方法 用酶联免疫吸附法（ＥＬＩＳＡ）测定维持性血液透析患者用不同种类透析膜透析过程中不同时间血浆ＳＣ５ｂ－９（补体终末复合物）浓度，并进行比较。结果 用ＣＵ膜（ｃｕｐｒｏｐｈａｎｅ ｍｅｍｂｒａｎｅ，铜仿膜）透析，透析过程中血浆ＳＣ５ｂ－９浓度变化最大；其次是用ＰＭＭＡ膜（ｐｏｌｙｍｅｔｈｙｌ ｍｅｔｈａｃｒｙｌａｔｅ，聚甲基丙烯酸甲酯膜）、ＨＥ膜（ｈｅｍｏｐｈａｎｅ ｍｅｍｂｒａｎｅ，血仿膜）。ＰＳＮ膜（ｐｏｌｙｓｙｎｔｈａｎｅ ｈｅｍｏｄｉａｌｙｓｅｒ，仿生膜）透析；ＨＥ膜用过氧乙酸和福尔马林消毒第４次复用，血浆ＳＣ５ｂ－９浓度变化幅度较首次使用明显降低（Ｐ＜０、０５）。结论 不同种类透析膜激活补体的能力不同，依次为：ＣＵ＞ＰＭＭＡ＞ＨＥ＞ＰＳＮ；ＨＥ膜用过氧乙酸和福尔马林消毒复用可在一定程度降低其激活补体的能力。

Objective To investigate the effects of different kinds of hemodialysis (HD) membrane on complement activation. Methods The plasma concentration of SC5b-9 complex was measured with EUSA at the time before and after the beginning of single session of hemodialysis with different kinds of dialysis membrane. Results The plasma concentrations of SC5b-9 complex were significantly different between membranes in the rank order: CU> PMMA> HE> PSN. Less change of the plasma concentration of SC5b-9 was found during a single session of HD in the patients with reused HE dialyzers than new ones. Conclusions Different kinds of dialyser membrane have different ability of complement activation: CU> PMMA> HE >PSN. Reused HE, which sterilized with peroxide or formalin, decreases its ability of complement activation.