高通量透析膜在血液透析中的应用

背景：高通量膜具有很高的通透性及溶质转运性能,透析中能有更多相对分子质量较大的溶质从血液转运到透析液中,故称之为高通量透析,属于一种高效血液净化治疗方法。目的：总结近年高通量透析膜在血液透析中的应用现状。方法：由作者应用计算机检索维普数据库,检索时限2000-02/2008-10。检索关键词：高通量透析膜;血液透析;临床应用。纳入标准：①高通量透析膜在血液透析中的应用。②实验结果叙述与材料有关的临床应用问题。排除标准：重复研究或较陈旧文献。根据纳入排除标准共保留相关文献12篇。结果与结论：与低通量血液透析相比可清除β2微球蛋白,降低透析患者血脂、血磷及甲状旁腺素水平,减轻炎症反应、氧化应激及血管内皮变化,不影响维持性血液透析患者血浆细胞因子及内毒素水平,对尿素氮、肌酐等小分子的清除也优于常规透析。因此,高通量透析可预防血液透析患者的远期并发症如肾性骨病,动脉硬化,并可改善食欲不振,高血压症状,提高透析的充分性。

High-flux dialysis membranes in hemodialysis

BACKGROUND：High-flux membrane is characterized as high permeability and solute transport properties.During dialysis,many solutes with relative large molecular weight transport from the blood into the dialysis fluid,called as high-flux dialysis,which is an efficient blood purification treatment.OBJECTIVE：To summarize the application of high-flux membranes in hemodialysis.METHODS：A computer based search of VIP database was performed to retrieve articles published from 2000-02 to 2008-10 using keywords of ＂high-flux dialysis membrane;hemodialysis;clinical application＂.The inclusive criteria were as follows：application of high-flux dialysis membranes in hemodialysis;materials-related clinical research.Repetitive or old articles were excluded.Finally,12 papers were included.RESULTS AND CONCLUSION：Compared with the low-flux one,the high-flux dialysis can clear β2-microglobulin,lower blood lipids,phosphorus and parathyroid hormone levels,reduce inflammation,oxidative stress,and endothelial changes in dialysis patients.It cannot affect the levels of plasma cell factors and endotoxin in patients receiving maintenance hemodialysis.In the remove of urea nitrogen and creatinine,the high-flux dialysis is also superior to conventional dialysis.Therefore,the high-flux dialysis can prevent long-term complications,such as renal osteodystrophy and atherosclerosis,improve loss of appetite and high blood pressure symptoms,and increase the adequacy of dialysis.