The effects of hemodialysis on platelet activation with new and reprocessed regenerated cellulose dialyzers.
The effects of hemodialysis on platelet activation with new and reprocessed regenerated cellulose dialyzers.
复制标题
使用新型和再加工的再生纤维素透析器进行血液透析对血小板活化的影响。
DOI：
10.1016/s0272-6386(96)90362-5
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
Santoro,S
中科院分区：
文献类型：
--
作者：
Windus,DW;Atkinson,R;Santoro,S
透析膜的生物相容性部分由激活凝血系统的倾向决定。评估凝血刺激的方法包括血小板活化标记物的分析。这些研究的目的是确定在使用再生纤维素膜进行常规血液透析期间高血流量和再处理对血小板活化的影响。在使用再生纤维素透析器进行常规慢性血液透析的患者中测量血小板 α 颗粒蛋白、β 血栓球蛋白 (BTG)。初步研究显示，BTG 水平从基线时的 24 ± 2 IU/mL 分别增加至 120 分钟和透析后的 30 ± 3 IU/mL 和 35 ± 4 IU/mL（P <0.05）。相反，用血浆蛋白浓度校正血液浓度的 BTG 水平与基线值相比没有显着变化。进一步的研究评估了两种新型和再加工的再生纤维素透析器在四种不同治疗过程中的效果。 10分钟和30分钟时的血小板计数与基线相比没有变化，而白细胞计数显着下降。当使用任一透析器校正血液浓度时，BTG 水平没有发生显着变化。使用新型和再加工的再生纤维素透析器进行的其他研究比较了 10 分钟时 450 和 220 mL/min 的血流量，结果表明 BTG 没有变化。总之，这些研究没有显示再生纤维素膜常规血液透析可激活血小板的证据。与之前研究的差异包括对由于超滤和透析器预冲洗造成的血液浓缩进行 BTG 校正。通过透析膜评估细胞活化的方法必须考虑血液浓缩。
Biocompatibility of dialysis membranes is defined, in part, by the tendency to activate the coagulation system. Methods for evaluating stimulation of the coagulation include analyses of markers of platelet activation. The purpose of these studies was to ascertain the effects high blood flow rates and reprocessing on platelet activation during routine hemodialysis with regenerated cellulose membranes. The platelet α-granule protein, β-thromboglobulin (BTG), was measured in patients undergoing routine chronic hemodialysis with regenerated cellulose dialyzers. Initial studies showed BTG levels to increase from 24 ± 2 IU/mL at the baseline to 30 ± 3 IU/mL and 35 ± 4 IU/mL at 120 minutes and postdialysis, respectively (P <0.05). In contrast, BTG levels corrected for hemoconcentration with plasma protein concentrations showed no significant changes compared with baseline values. Further studies assessed the effects of two types of new and reprocessed regenerated cellulose dialyzers during four different treatments. Platelet counts at 10 and 30 minutes did not change compared with the baseline, while white blood cell counts decreased significantly. No significant changes in BTG levels occurred when corrected for hemoconcentration with either dialyzer. Additional studies with new and reprocessed regenerated cellulose dialyzers comparing 450 and 220 mL/min blood flow rates at 10 minutes showed no changes of BTG. In summary, these studies show no evidence for platelet activation by routine hemodialysis with regenerated cellulose membranes. Differences from previous studies include correction of BTG for hemoconcentration due to ultrafiltration and prerinsing of dialyzers. Methods for assessment of cellular activation by dialysis membranes must account for hemoconcentration.