| 特集名 | アミロイド骨・関節症 -- 診断と治療の実際 | |
|---|---|---|
| 題名 | 治療 (2) β2-ミクログロブリン吸着カラムによる治療 | |
| 発刊年月 | 1997年 08月 | |
| 著者 | 中澤 了一 | 東葛クリニック病院腎臓内科 |
| 【 要旨 】 | 透析アミロイドーシス(DRA)は，血中でのβ2-microg1obulin(β2-MG)の異常蓄積を背景としている．この血中のβ2-MGを除去するため，β2-MG選択的吸着体が直接血液灌流(DHP)用に開発されてきた．350 mlの吸着体を充填したカラム(BM-01，リクセル)を透析器と連結して臨床的に検討した． β2-MGの平均血漿クリアランスは，HD45.4±4.1,HDF(5l)49.1±7.8,DHP+HD89.4±9.2,HD+DHP88.7±9.8 ml/minであった．カラム併用例でADL，関節痛，関節可動域，こわばりの改善がみられた． BM-01は，透析患者からのβ2-MGの除去にとって有用な医療用具であり，この選択的吸着療法がDRAの進行を遅延させる可能性がある． |
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| Theme | Amyloid-Related Bone and Joint Derangements -- Clinical Diagnosis and Treatment | |
|---|---|---|
| Title | Selective extracorporeal removal of beta2-microglobulin with adeorbent column in dialysis-related amyloidosis (DRA) | |
| Author | Ryoichi Nakazawa | Tokatsu Clinic Hospital, Department of Nephrology |
| [ Summary ] | The cause of DRA has been proven to be the undesirable accumulation of beta2-microglobulin (beta2-MG) in serum. In order to eliminate beta2-MG from circulating blood, a beta2-MG selective adsorbent for direct hemoperfusion (DHP) was developed. A DHP column (BM-0l; LixelleTM) containing 350 ml of the adsorbent, was connected with a dialyzer in series and clinical trials were conducted. Plasma clearances for beta2-MG were calculated to be 45.4+-4.1 (HD), 49.1+-7.8 (HDF ; 5l), 89.4 +-9.2 (DHP + HD), and 88.7 +-9.8 (HD+DHP) ml/min. With DHP therapy, improvements in ADL, joint pain, joint mobility, and stiffness were observed. It can be concluded that BM-01 is a useful device for eliminating beta2-MG from dialysis patients and that this selective adsorption therapy may delay the progression of DRA. |
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