Deck K A, Fischer B, Hillen H
Eur J Clin Invest. 1979 Jun;9(3):203-7. doi: 10.1111/j.1365-2362.1979.tb00924.x.
Plasma clearance rates and dialysance of labelled cortisol were measured in patients on chronic intermittent dialysis during and after dialysis. Plasma clearance rates during dialysis were 30--63% higher than after dialysis; dialysance was 0.3--0.7 1/h and accounted only for 20--35% of the increase of plasma clearance rates during dialysis. After bolus injection of labelled cortisol, disappearance curves were obtained in two normal subjects and two uraemic subjects on and off dialysis. Biological halftimes of the different segments of the disappearance curves and distribution volumes were calculated. The size of the inner compartment (V1) is greater in uraemia. The disappearance curves flatten after the end of dialysis, indicating an increase of biological halftime after dialysis. Plasma 17-OHCS-glucuronides dropped from 2.13 +/- 0.62 micromol/l (n = 20) at the beginning to 1.05 +/- 0.65 micromol/l at the end of dialysis and increased to 1.51 +/- 0.43 micromol/l (n = 12) within 3 h thereafter. During dialysis cortisol metabolites are removed from the blood. This may decrease inhibition of cortisol metabolism by the end products of cortisol metabolism which might explain the more rapid plasma clearance and the shortened cortisol half-life during haemodialysis.
在慢性间歇性透析患者透析期间及透析后，测量了标记皮质醇的血浆清除率和透析率。透析期间的血浆清除率比透析后高30% - 63%；透析率为0.3 - 0.7升/小时，仅占透析期间血浆清除率增加量的20% - 35%。在对两名正常受试者以及两名透析和未透析的尿毒症受试者静脉注射标记皮质醇后，获得了清除曲线。计算了清除曲线不同部分的生物半衰期和分布容积。尿毒症患者体内室（V1）的大小更大。透析结束后清除曲线变平缓，表明透析后生物半衰期延长。血浆17 - OHCS - 葡糖醛酸苷在透析开始时为2.13±0.62微摩尔/升（n = 20），在透析结束时降至1.05±0.65微摩尔/升，并在之后3小时内升至1.51±0.43微摩尔/升（n = 12）。透析期间皮质醇代谢产物从血液中被清除。这可能会减少皮质醇代谢终产物对皮质醇代谢的抑制作用，这或许可以解释血液透析期间血浆清除更快以及皮质醇半衰期缩短的现象。
