【摘要】 目的 :比较不同种透析膜在常规血液透析中对磷的清除效果 ,探讨可能的清除机理。方法 :选 14例病情稳定、有高磷血症的慢性维持性血透患者 ,分别采用面积为 1.3m2 的铜仿膜、三氯醋酸纤维素膜、双氯醋酸纤维素膜、血仿膜及高通量聚砜膜 (F6 0 )透析器进行常规血液透析。结果 :透前透后血磷的下降幅度血仿膜为 5 7.6 %± 8.1% ,三氯醋酸纤维素膜 4 8.5± 4 .3% ,双氯醋酸维素膜 4 5 .9%± 10 .1% ,铜仿膜 4 5 .1%± 4 .8% ,F6 0 4 8.2 %± 7.3% ,血仿膜的下降幅度与其他种膜比较有显著差异 (P<0 .0 5 )。测定滤出液中磷浓度及磷清除率 ,血仿膜较其他均低有显著差异 (P<0 .0 1)。血仿膜对磷有吸附作用 ,其吸附量为 (0 .6 8± 0 .12 ) mmol/L。透析后血磷又回跃 ,透后 4 8小时已达到透前水平。结论 :在常规血液透析中血仿膜对磷的清除优于其他种膜 ,但由于透后血磷回跃 ,透析患者的高磷血症难以纠正到理想效果更多还原

【Abstract】 Objective:We made a comparative study of different membranes to determine the mechanism and effect of study their removing phosphoru in routine hemodialysis.Mothods:We selected fourteen patients in maintenance hemodialysis with hyperphosphatemia and made a routine hemodialysis for them using a dialyzer separately with the same area of 1.3m 2 membrane cellulose triacetate membrane,cellulose diacetate membrane,hemophan membrane and high flua polysulfon membrane.Result:The levels of dropping in serum phosphoru in pre and post hemodialysis in different membrane are as follows:hemophan dropped 57.6%±8.11%;cellulose triacetate membrane 48.5%±4.3% cellulose diacetate membrane 45.9%+10.1%,and high flux polysulfon membrane 48.2%±7.3%,hemophan membrane compared with other membranes in the dropping levels is the best (P<0.05).We tested the concentration and dearance rate in filtrate,and found that hemophan membrane is lower than the other membranes (P<0.01).The reason of which may be the adsorbing effect in hemophan membrane and the adsorbing amount being 0.68±0.12 mmol/L In addition the serum phosphorce will rebound after dialysis and return to the level of the pre dialysis after forty eight hours.Conclusion:The clearance of serum phosphoru with hemophan membrane in routine hemodialysis is better than the other membranes.But owing to the resumption of the serum phosphoru after dialysis,it seems difficult to correct the hyperphosphatemia to an ideal effect in dialytic patients更多还原