加氢气的新型血液透析的临床研究

长期血液透析引起的慢性炎症是预后不良的重要原因。但是，治疗长期血液透析引起的慢性炎症的手段非常有限。许多动物实验结果发现，氢气具有器官氧化和炎症损伤的良好保护作用。我们用含氢气电解液开发出新型血液透析系统，并进行了临床效应观察。用电解方法制备氢气并将氢气溶解到反渗水中并和透析液混合，氢气浓度可达到48 ppb。受试对象为病情稳定使用常规透析液治疗的21名患者，换用新含氢气透析液6月，每周三次治疗。结果发现，在治疗过程中，没有任何明显的不良反应，比较突出的效果是，透析后血压正常比例明显增加，治疗前只有21%收缩压低于140 mmHg，而新透析后达到62%，有显著统计学区别。虽然透析相关指标没有明显变化（透析效果无区别？），但血液中代表炎症反应的MCP1和MPO显著下降。该研究表明，加氢气新型透析液对血压控制效果良好，并能有效控制炎症反应。该新型透析液给尿毒症患者带了福音。要知道，这种新型透析液成本并不增加多少。

Nephrol Dial Transplant. 2010 Apr 12. [Epub ahead of print]

A novel bioactive haemodialysis system using dissolved dihydrogen (H2) produced by water electrolysis: a clinical trial.

Nakayama M, Nakano H, Hamada H, Itami N, Nakazawa R, Ito S.

1 Tohoku University Hospital, Department of Blood Purification (Sendai).

Abstract

Background. Chronic inflammation in haemodialysis (HD) patients indicates a poor prognosis. However, therapeutic approaches are limited. Hydrogen gas (H(2)) ameliorates oxidative and inflammatory injuries to organs in animal models. We developed an HD system using a dialysis solution with high levels of dissolved H(2) and examined the clinical effects. Methods. Dialysis solution with H(2) (average of 48 ppb) was produced by mixing dialysate concentrates and reverse osmosis water containing dissolved H(2) generated by a water electrolysis technique. Subjects comprised 21 stable patients on standard HD who were switched to the test HD for 6 months at three sessions a week. Results. During the study period, no adverse clinical signs or symptoms were observed. A significant decrease in systolic blood pressure (SBP) before and after dialysis was observed during the study, and a significant number of patients achieved SBP <140 mmHg after HD (baseline, 21%; 6 months, 62%; P < 0.05). Changes in dialysis parameters were minimal, while significant decreases in levels of plasma monocyte chemoattractant protein 1 (P < 0.01) and myeloperoxidase (P < 0.05) were identified. Conclusions. Adding H(2) to haemodialysis solutions ameliorated inflammatory reactions and improved BP control. This system could offer a novel therapeutic option for control of uraemia.

PMID: 20388631 [PubMed - as supplied by publisher]