Accumulation of silicone elastomer in regular dialysis.

T Laohapand, E M Osman, A R Morley, M K Ward, D N Kerr
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Abstract

A retrospective autopsy study of 78 patients treated by some form of dialysis for chronic renal failure in Newcastle 1964-1981 showed that: 1) Particles resembling silicone elastomer were present in 48 per cent of 61 patients haemodialysed with the use of silicone rubber pump inserts but in none of the 11 treated by haemodialysis with other pump inserts or of the six treated by peritoneal dialysis alone; 2) The prevalence of these particles and their density increased with time on haemodialysis; 3) There was little evidence of a tissue reaction to the particles and no association between their presence and histological evidence of liver disease; 4) There was a higher incidence of clinical and biochemical evidence of liver disease in patients with silicone deposits than in those without. Although there are other possible explanations for this higher incidence of hepatic dysfunction it would be safer to assume that silicone particle spallation is not innocuous.

常规透析中有机硅弹性体的积累。
一项对纽卡斯尔(Newcastle) 1964-1981年间接受某种形式透析治疗的78例慢性肾衰竭患者的回顾性尸检研究表明:1)在61例使用硅橡胶泵植入物进行血液透析的患者中,48%的患者体内存在类似硅橡胶弹性体的颗粒,但在11例使用其他泵植入物进行血液透析的患者中,或在6例单独进行腹膜透析的患者中,没有出现类似硅橡胶弹性体的颗粒;2)随着透析时间的延长,这些颗粒的流行率和密度增加;3)几乎没有证据表明组织对这些颗粒有反应,它们的存在与肝脏疾病的组织学证据之间没有关联;4)有机硅沉积患者的肝脏疾病的临床和生化证据发生率高于无有机硅沉积患者。尽管对于肝功能障碍的高发生率有其他可能的解释,但更安全的假设是硅胶颗粒碎裂不是无害的。
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