Development of a new hemopurification therapy using recycle filtration system.

研制了一种新型循环过滤血液净化系统。该新系统与传统透析一样安全，可防止透析液中的内毒素回染;不需要置换液;可应用于血液滤过、连续性血液滤过、血液透析滤过和连续性血液透析滤过治疗。一项使用血液滤过引流液的体外实验表明，再循环液流量增加伴随着透析装置中尿素氮（UN）和肌酐（Cr）清除率增加，过滤装置中β-2-微球蛋白（β- MG）清除率增加，以及再循环率降低。在24小时连续再循环期间，未观察到透析单元中β- MG清除率随时间的显著降低。在第一个过滤器中使用牛血和聚砜膜的体外实验中，即使使用自来水复溶的透析液，在再循环液体中也未检测到内毒素。在血流量为210 ml/min、循环液流量为80 ml/min时，UN、Cr和β 2- MG的清除率分别为80.9 × 1.0、72.0 × 2.5和40.1 × 0.9 ml/min。结果表明，RF系统可用于维持性透析。RF对尿素氮、肌酐、尿酸、磷酸盐、β-微球蛋白的降低率不低于血液滤过法。当再生液体积高达20升时，再生效率完全取决于再生液体积。RF治疗前后血液分析无明显变化，PIP治疗期间未发现临床不良反应。RF系统被认为是一种有用的血液净化治疗慢性和急性肾功能衰竭，也是在重症监护室治疗。

A new recycle filtration (RF) system for blood purification was developed. This new system is as safe as a conventional dialysis against endotoxin back contamination form the dialysate ; does not require substitution fluid ; and can be applied to hemofiltration, continuous bemofiltration, hemodiafiltration and continuous hemodiafiltration therapies. An in vitro experiment using drain fiuid from hemofiltration showed that an increased recycle fluid flow is accompanied by increased urea nitrogen (UN) and creatinine (Cr) clearances in the dialysis unit and increased beta- 2- microglobulin (beta- MG) clearance in the filtration unit, and a lowered recycle rate. No significant decrease in beta- MG clearance with time in the dialysis unit was observed during 24 hours of continuous recycle. In an in vitro experiment using bovine blood and a polysulfone membrane in the first filter, endotoxin was not detected in the recycled fluid even with a dialysate reconstituted by tap water. At a blood flow of 210 ml/min and recycle fluid flow of 80 mVmin, the respective clearauce of UN,Cr and beta 2- MG was 80.9 * 1.0, 72.0 * 2.5 and 40.1* 0.9 mVmin. These results suggest that the RF system may be used in maintenance dialysis .Clinical efficiency of RFS were studied. Efficiency of reduction rate in urea UN, Cr, uric acid(UA), phosphate(IP), beta-MG with RF were no less than that of hemofiltration (HF) method. The efficiency was completely dose depending on regeneration fluid volume up to 20 litter. There was no significant change in blood analysis with RF.No clinical adverse effect was recognized of patients during PIP treatment. RF system was considered to be a useful hemopurification therapy for chronic and acute renal failure and also for treatment in intensive care unit.