评价有辅助设备的血液成分分离系统
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By Liu Jianrong, news writer 刘建荣 新闻记者 Posted on 12 Nov 2017 |
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图片：Spectra Optia血液成分分离系统（照片由Terumo BCT提供）。
血浆置换疗法（TPE）降低患者血浆中循环的病理性因子水平，并缓解症状或预防受累组织或系统的进一步受损。
作为TPE的一种替代方法，已开发特定的血浆纯化法，如脂蛋白分离治疗或免疫吸附法，用于选择性去除单独的血浆中的所谓的病理物质。
University Hospital Jena（Germany）的科学家检验了2015年11月至2016年10月间最后300份数据日志文件。在这300份操作中，对13名患者进行了149次辅助血浆治疗，76份进行免疫吸附（IA），73份进行脂蛋白分离治疗（LA）。9名患者由于接受移植和有自身免疫疾病而接受IA。4名患者在心脏移植后接受LA。这些操作中，62%使用外周静脉导管，甚至对入口血流速度小的患者也如此。
所有患者接受Spectra Optia血液成分分离系统（Terumo BCT，Lakewood，CO，USA）治疗。使用一种吸附矩阵Immunosorba（Fresenius Medical Care Deutschland GmbH，Bad Homburg，Germany）进行IA，并使用Fresenius Medical Care Monet 或 Evaflux（Kawasumi Laboratories，Tokyo，Japan）进行LA。免疫吸附（IA）柱需要额外的设备进行二次血浆处理。吸附设备（Medicap GmbH，Ulrichstein，Germany）允许对色谱柱进行吸附和解吸（再生）处理。这些设备在一系列处理中最多能处理一万毫升血浆。
仅15%的标本需要中心静脉导管，23%的处理有动静脉瘘。两种过程的抗凝处理方法不同。LA程过程要更大量的柠檬酸盐，因为其仅使用柠檬酸盐。IA过程需要的柠檬酸盐量较少，因为其使用柠檬酸盐和肝素的混合物。无论是否使用肝素，科学家都未观察到凝固和出血。由于严格控制了钙，没有患者出现低钙血症的体征。他们发现，目标物质可显著减少：脂蛋白a（Lpa）水平以低密度脂蛋白计算，从68%减少到57%，以免疫球蛋白G（IgG）计算，从6.6g/L减少到2.61%。
作者们得出结论，Spectra Optia的血浆萃取效率高，允许辅助血浆设备程序使用外周静脉和中等流速。Optia的最大优势之一是有高血浆清除效率。过滤器或IA柱的理想血浆流速能更快。本研究已发表于2017年5月24日刊的International Journal of Clinical Transfusion Medicine（国际临床输血医学杂志）。
Related Links:
University Hospital Jena
Terumo BCT
Fresenius Medical Care
Kawasumi Laboratories
Medicap GmbH
作为TPE的一种替代方法，已开发特定的血浆纯化法，如脂蛋白分离治疗或免疫吸附法，用于选择性去除单独的血浆中的所谓的病理物质。
University Hospital Jena（Germany）的科学家检验了2015年11月至2016年10月间最后300份数据日志文件。在这300份操作中，对13名患者进行了149次辅助血浆治疗，76份进行免疫吸附（IA），73份进行脂蛋白分离治疗（LA）。9名患者由于接受移植和有自身免疫疾病而接受IA。4名患者在心脏移植后接受LA。这些操作中，62%使用外周静脉导管，甚至对入口血流速度小的患者也如此。
所有患者接受Spectra Optia血液成分分离系统（Terumo BCT，Lakewood，CO，USA）治疗。使用一种吸附矩阵Immunosorba（Fresenius Medical Care Deutschland GmbH，Bad Homburg，Germany）进行IA，并使用Fresenius Medical Care Monet 或 Evaflux（Kawasumi Laboratories，Tokyo，Japan）进行LA。免疫吸附（IA）柱需要额外的设备进行二次血浆处理。吸附设备（Medicap GmbH，Ulrichstein，Germany）允许对色谱柱进行吸附和解吸（再生）处理。这些设备在一系列处理中最多能处理一万毫升血浆。
仅15%的标本需要中心静脉导管，23%的处理有动静脉瘘。两种过程的抗凝处理方法不同。LA程过程要更大量的柠檬酸盐，因为其仅使用柠檬酸盐。IA过程需要的柠檬酸盐量较少，因为其使用柠檬酸盐和肝素的混合物。无论是否使用肝素，科学家都未观察到凝固和出血。由于严格控制了钙，没有患者出现低钙血症的体征。他们发现，目标物质可显著减少：脂蛋白a（Lpa）水平以低密度脂蛋白计算，从68%减少到57%，以免疫球蛋白G（IgG）计算，从6.6g/L减少到2.61%。
作者们得出结论，Spectra Optia的血浆萃取效率高，允许辅助血浆设备程序使用外周静脉和中等流速。Optia的最大优势之一是有高血浆清除效率。过滤器或IA柱的理想血浆流速能更快。本研究已发表于2017年5月24日刊的International Journal of Clinical Transfusion Medicine（国际临床输血医学杂志）。
Related Links:
University Hospital Jena
Terumo BCT
Fresenius Medical Care
Kawasumi Laboratories
Medicap GmbH
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