CAJ | 학술논문

目的通过建立血液净化连续静-静脉血液透析滤过(CVVHDF)模式前、后稀释方法的体外实验,探讨该模式前、后稀释法对各种不同大小的溶质分子清除效率的影响.方法建立等容CVVHDF前、后稀释及CVVH单循环(无稀释、无透析)对照体外实验装置,比较不同相对分子质量物质钾(K+)、肌酐(Cr)、万古霉素(vancomycin)、胰岛素(insulin)和白细胞介素-6(IL-6)的清除率,实验重复4次(n=4).结果 CVVHDF后稀释法对K+、Cr、Vancomycin和Insulin清除率明显高于CVVHDF前稀释;CVVHDF前、后稀释对IL-6清除差异无统计学意义;对照组Insulin和IL-6实验结束时明显降低.结论 CVVHDF后稀释总体上对各种不同相对分子质量物质清除率高于前稀释,但随着相对分子质量的增大,两者间的差别缩小;对照组提示实验用滤器(AN69)对Insulin及IL-6有吸附作用.
목적 통과건립혈액정화련속정-정맥혈액투석려과(CVVHDF)모식전、후희석방법적체외실험,탐토해모식전、후희석법대각충불동대소적용질분자청제효솔적영향.방법 건립등용CVVHDF전、후희석급CVVH단순배(무희석、무투석)대조체외실험장치,비교불동상대분자질량물질갑(K+)、기항(Cr)、만고매소(vancomycin)、이도소(insulin)화백세포개소-6(IL-6)적청제솔,실험중복4차(n=4).결과 CVVHDF후희석법대K+、Cr、Vancomycin화Insulin청제솔명현고우CVVHDF전희석;CVVHDF전、후희석대IL-6청제차이무통계학의의;대조조Insulin화IL-6실험결속시명현강저.결론 CVVHDF후희석총체상대각충불동상대분자질량물질청제솔고우전희석,단수착상대분자질량적증대,량자간적차별축소;대조조제시실험용려기(AN69)대Insulin급IL-6유흡부작용.
Objective To compare the rates of clearance of different solutes during continuous veno-venous haemodiafiltration (CVVHDF) between pre-dilution and post-dilution.Methods A study in vitro was carried out using model CRRT system with AN69 filter used,which was applied to perform CVVHDF for solutes clearance.The removed amounts of different solutes including potassium ion (K +),creatinine (Cr),vancomycin,insulin,and interleukin-6 (IL-6) were determined in the groups of control (without dilution),pre-dilution and post-dilution during CVVHDF at the same substitution fluid amount.Each group was repeated 4 times (n =4).Results Post-dilution mode increased K +,Cr,vancomycin and insulin clearances significantly.There was no difference in clearance of IL-6 between the pre-and post-dilution groups.In the control group,insulin and IL-6 levels were decreased extremely.Conclusions In general,the rate of clearance using post-dilution of CVVHDF is higher than that using pre-dilution.Among high molecular weight solutes,the difference in clearance is not significant.The control group demonstrates insulin and IL-6 adsorbed by the filter.