摘要
目的探讨低透析液流量每日血透时 ,血流量和透析液流量对溶质清除率及清除效率的影响。方法建立单次循环的体外血液透析实验装置 ,使用新鲜牛全血 ,Hct为 (33± 2 ) % ,血浆总蛋白为 (6 .0± 0 .5 )g/dL。实验血流量 (Qb)分别为 :30 0、4 5 0、6 0 0mL/min;透析液流量 (Qd)分别为血流量的 1/ 6、1/ 4和 1/ 3;超滤率 0。每对Qb 和Qd/Qb 组合重复实验 6 0min× 3次。测定尿素、肌酐、万古霉素和菊粉的清除率和清除效率。结果当Qb 固定时 ,随着Qd/Qb 增加 ,尿素和肌酐清除率显著增加 (P <0 .0 5 ) ;万古霉素和菊粉清除率亦增加 ;尿素、肌酐和菊粉的清除效率显著降低 (P <0 .0 5 ) ,万古霉素清除效率逐渐降低 ,但无统计学差异。当Qd/Qb 固定时 ,随着Qb 增大 ,尿素、肌酐清除率显著增加 (P <0 .0 5 ) ,万古霉素和菊粉的清除率亦增加 ;溶质透析液侧清除效率显著降低 (P <0 .0 5 )。结论低透析液流量每日血透时 ,两对Qb 与Qd/Qb 组合均可获得相似的、较理想的溶质清除效果。
Objective To evaluate the solute clearance with a range of molecular weights from whole blood at low dialysate flow rates using daily hemodialysis configuration. Methods In vitro daily hemodialysis model employing Q uf of 0, Q b of 300, 450, and 600 ml/min, and Q d will be 1/6, 1/4, and 1/3 of the Q b, respectively. We determined the variable Q b (bovine blood, hematocrit 33±2 %, total plasma protein concentration 6.0±0.5 g/dL) and Q d/Q b matrix on urea, creatinine, vancomycin and inulin clearances and clearance efficiency, N=3 for each Q b and Q d/Q b combination. Solute clearances of urea, creatinine, vancomycin and inulin were determined by routine methods. Results As Q d/Q b increased, clearances of urea and creatinine significantly raise (P<0.05) and clearances of vancomycin and inulin progressively rise for given Q b. Meanwhile, clearance efficiency of urea, creatinine and inulin significantly falls (P<0.05), and clearance efficiency of vancomycin progressively falls. For given Q d/Q b, clearance of urea and creatinine significantly raise (P<0.05) and clearance of vancomycin and inulin raise as Q b increased. At the same time clearance efficiency of these solutes significantly falls (P<0.05). Conclusion Two combinations of Q b and Q d/Q b will achieve the same and the optimal solutes clearance and clearance efficiency in daily hemodialysis.
出处
《上海第二医科大学学报》
CSCD
2004年第B11期22-24,33,共4页
Acta Universitatis Medicinalis Secondae Shanghai
