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투석막의 종류에 따른 혈액투석중 혈소판 활성과 섬유소성 용해계의 변동
이영호(Young Ho Lee),권영주(Young Joo Kwon),표회정(Heui Jung Pyo),김성권(Suhng Gwon Kim),이정상(Jung Sang Lee) 대한내과학회 1994 대한내과학회지 Vol.46 No.6
N/A Background: The biocompatibility of dialysis membranes can be assessed by several ways including complement activation, the degree of leukopenia and the release of cytokine. The activation of platelet and fibrinolytic system can also be used as an index of biocompatibility. Method: We investigated the serial changes of the platelet count, platelet aggregate ratio (PAR) and plasma β-thromboglobulin (β-TG) before and during hemodialysis using two different kinds of membrane (cuprophane and PMMA). We also measured the plasma concentration and activity of fibrinolytic proteins such as plasminogen antithrombin-III (AT Ill) and a2-plasmin inhibitor (a2 -PI) during hemodialysis at 0, 30, 60, 120 and 180. Result: 1) Platelet count was significantly decreased at 30' (p<0.05) and recovered after 60 of hemodialysis in both types of membrane. 2) PAR showed increasing tendency at 120 in both membranes, but there was no significant difference between the membranes. 3) β-TG was continuously increased in both membranes (p<0.05). 4) The concentrations of AT UI (180') and a2-PI (30', 60') were significantly decreased only in cuprophane membrane (p<0.05), There were significant differences in concentrations of AT III (120', 180') and a2-PI (30', 60', 120') between membranes (p<0.05). 5) The concentrations of plasma plasminogen showed no significant changes in both membranes. 6) The activities of AT III, a2-PI, plasminogen showed no significant serial change in both membranes during hemodialysis. Conclusion: PMMA membrane also activates platelet during hemodialysis but causes less alterations in fibrinolytic proteins than cuprophane membrane.
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한국형 출혈열 환자에서 병기에 따른 혈중 Atrial Natriuretic Polypeptide 농도의 변화
박정의(Jeong Euy Park),송치욱(Chi Wook Song),송관규(Gwan Gyu Song),표회정(Heui Jung Pyo),박승철(Seung Chull Park),이창홍(Chang Hong Lee),김대원(Dae Won Kim),이갑노(Kap Ro Lee),양영선(Yung Sun Yang),황흥곤(Heung Kon Hwang),문정식(Jung 대한내과학회 1987 대한내과학회지 Vol.33 No.6
N/A The plasma atrial naturiuretic polypeptide (ANP) was repeatedly measured in each clinical phases in 20 patients (20.8±7.2yr) with Korean Hemorrhagic Fever (KHF). The study purpose was to see whether there is any relationship between the clinical course of KHF and the changes of plasma level of ANP. In three patients the plasma ANP could be repeatedly measured from the early oliguric to diruetic phases. In these three patients the plasma level of renin activity and aldosterone were very high in the early oliguric phase. Then the plasma renin activity and aldosterone level decreased steeply in remarkable degree to near normal level while the patient is still in oliguric phase and stayed at this level during the diuretic phase. The plasma ANP level was low (30-80pg/ml) in the early oliguric phase. Then with the sudden remarkable decrease of plasma renin activity and aldosterone the plasma ANP increased rapidly to high level (230-280pg/ml), then was decreased to near normal level (90-190pg/ml) making a narrow peaked plasma ANP concentration curve, and then the level stayed at near normal level during the diuretic phase. Around the time when the plasma renin activity and aldosterone concentrations were decreased to their low level and the plasma ANP was increased to it's peak level the oliguric phase was changed to the diuretic phase. The changes of plasma cortisol level followed the pattern of changes of plasma renin and aldosterone. It is possible that the increase of plasma ANP level might have had some role in the initiation of diuretic phase in these patients. It is not certain whether these changes are the unique changes seen only in patients with KHF or the changes seen also in patients with acute renal failure of other causes.
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