三醋酸纤维素膜与聚砜膜透析器在维持性血液透析患者的多中心临床研究
Chinese Journal of Blood Purification（2023）
中国医科大学附属盛京医院 | 110024沈阳 | 123099阜新 | 110623沈阳
Abstract
目的 对比长期透析治疗时,三醋酸纤维素膜(cellulose triacetate,CTA)及聚砜膜(poly-sulfone,PS)透析器生物相容性和溶质清除能力的差异.方法 根据患者是否耐受聚砜膜透析器,分为PS组与CTA组,对比2种透析膜单次透析前后及第12个月透析后血小板(PLT)、血红蛋白(Hb)、补体、肿瘤坏死因子-α(TNF-α)、IL-6、免疫球蛋白E(IgE)、血磷(P)、尿素氮(BUN)、β2-微球蛋白(β 2-MG)、甲状旁腺激素(PTH)等差异,计算尿素清除率(urea removal rate,URR)和spKt/V.结果 单次透析后较透析前各指标差值比较PS组TNF-α差值(Z=-2.491,P=0.013)低于CTA组,而β2-MG差值(Z=-2.039,P=0.041)高于CTA组.规律血液透析治疗12个月后CTA组与PS组间血磷(Z=-2.096,P=0.036)、BUN(Z=-2.038,P=0.042)、spK t/V(t=-2.147,P=0.049)差异具有统计学意义.PS组患者在透析12个月后与透析前的血磷差值高于CTA组(t=0.114,P=0.041).结论 ①单次透析后,PS组TNF-α水平升高,CTA的生物相容性优于PS.CTA组对β2-MG的清除能力优于PS.②长期透析后,两者具有相似的生物相容性.CTA组spK t/V达到标准,对BUN、P的清除能力优于PS.
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