不同复用处理对聚砜血液透析器膜功能的影响

目的定量比较次氯酸盐和过氧乙酸复用处理法对Fresenius F80B聚砜血液透析器膜清除率和表面电性的影响。方法应用尿素、维生素B12和多分散葡聚糖作为特征溶质,在体外模拟的透析装置上进行清除率实验,分别测定新F80B、体外透析血浆3h后以及次氯酸盐和过氧乙酸复用处理后透析器上的清除率、超滤系数和ζ电位。结果次氯酸盐可有效去除膜上蛋白质沉积,恢复清除率;其与透析器膜材料反应,使膜表面负电荷增加;随着接触时间的加长,可改变透析器膜的传质特性,使溶质清除率增加。过氧乙酸复用处理后,膜孔内或表面残留的蛋白质使大分子葡聚糖清除率有极大降低。结论次氯酸盐与过氧乙酸两种复用处理,对F80B聚砜血液透析器清除率和表面电性可产生不同的作用。

Effects of reprocessing techniques on function of polysulfone hemodialysis membranes

Objective To quantitatively compare the effects of bleach and peracetic acid reprocessing on the clearance and surface charge characteristics of Fresenius F80B polysulfone dialyzers. Methods Clearance experiments were performed using urea, vitamin B_12, and polydisperse dextrans in an in vitro dialysis circuit. Clearance, ultrafiltration coefficient and zeta potential were obtained on a new F80B dialyzer, after exposure to plasma in a 3 h in vitro dialysis session, and after cleaning with bleach and peracetic acid.Results Bleach was able to remove the protein deposit, restoring the clearance characteristics, but there was a significant increase in the net negative charge of the membrane due to chemical reaction with the bleach. In addition, longer time exposure to bleach altered the membrane transport characteristics, increasing the solute clearance. Dialyzers cleaned with peracetic acid had significantly lower clearance of the larger dextrans due to the presence of residual protein on or within the membrane. Conclusion Cleaning with bleach and peracetic acid may have dramatically different effects on the clearance and surface charge characteristics of F80B polysulfone dialyzers.