首次在人体中使用零溶液直接去除的经验:用于体积过载的新候选疗法
Veena S Rao1, Jeffrey M Turner2, Matthew Griffin1
1Department of Internal Medicine, Section of Cardiovascular Medicine (V.S.R., M.G., D.M., N.B., J.M. Testani), Yale University School of Medicine, New Haven, CT.
Circulation
|January 9, 2020
概括
在临床前和人体研究中,使用无溶液直接去除 (DSR) 有效地去除了大量的. 这种新的方法对心力衰竭患者的过多液体负荷有好处.
科学领域:
- 肝脏病学
- 心脏病学
- 生物医学工程
背景情况:
- 循环利尿剂在心力衰竭 (HF) 中常见,但有毒性并且可能失去有效性.
- 需要采用其他策略来维持HF患者的血流.
- 通过腹膜直接去除 (DSR) 是一种非脏取方法,使用无的透溶液.
研究的目的:
- 描述DSR的临床前发展.
- 建立一个首次在人类的概念证明.
- 评估DSR在管理流体过载方面的安全性,有效性和可扩展性.
主要方法:
- 在猪的临床前研究中,使用10%的乳糖溶液研究了DSR,评估了实验性心力衰竭的停留时间,安全性和可扩展性.
- 一项人类概念验证研究,随机分别分别分别分别分别分别分别分别分别分别分别分别分别分别分别分别分别分别分别分别分别分,分别分别分别分别分别分别分别分别分,分别分别分别分别分别分别分.
- 主要终点是耐受性;次要终点是去除差异.
主要成果:
- 在猪身上进行的研究表明,DSR在2小时内清除了4. 1g的,电解质稳定,离位溶液的清除最小.
- 在猪体内增加的DSR增强了的去除和减少了血体积.
- 人类研究表明,DSR耐受性良好,除掉的含量明显高于标准PD (4. 5g与1. 0g),电解质稳定,除掉的溶液量微不足道.
结论:
- 直接去除 (DSR) 在动物和人类中耐受良好.
- 与标准腹腔透析相比,DSR实现了较大的去除.
- 需要进一步的研究来评估DSR的预防和治疗心力衰竭的高血压.
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