慢性肾衰竭中哇巴因血浆水平动力学及透析清除情况。对14例患者的研究。

Ouabain plasma level kinetics and removal by dialysis in chronic renal failure. A study in fourteen patients.

作者信息

Selden R, Haynie G

出版信息

Ann Intern Med. 1975 Jul;83(1):15-9. doi: 10.7326/0003-4819-83-1-15.

Abstract

Ouabain plasma level kinetics and removal by dialysis were studied in 14 dialysis-dependent patients with chronic renal failure. Each received one 400 mug intravenous dose of unlabeled ouabain (9 patients also received 83 muCi of 3-H-ouabain) at the onset of a routine 4-hour hemodialysis. Plasma concentration fell rapidly the first few hours, and after 5 to 10 hours declined exponentially with a mean half-life of 50 plus or minus 19 (SD) hours. Ouabain recovery in dialysis bath was 11.5% plus or minus 2.2% the first 2 hours and only 3.4% plus or minus 0.5% the next 2 hours after an intravenous dose, due to rapid removal of ouabain from the extracellular fluid compartment by tissue uptake. Hence, hemodialysis is relatively ineffective for reducing ouabain body stores. Ouabain elimination in patients with chronic renal failure is significantly slower than in normal subjects (P smaller than 0.01), but significantly more rapid than that reported for digoxin (P smaller than 0.01) and digitoxin (P smaller than 0.01) in patients with chronic renal failure, a potentially useful characteristic in treating acute cardiac problems among such patients.

摘要

对14例依赖透析的慢性肾衰竭患者的哇巴因血浆水平动力学及透析清除情况进行了研究。在常规4小时血液透析开始时，每位患者静脉注射一剂400微克未标记的哇巴因（9例患者还接受了83微居里的3 - H - 哇巴因）。最初几个小时血浆浓度迅速下降，5至10小时后呈指数下降，平均半衰期为50±19（标准差）小时。静脉给药后，透析浴中哇巴因的回收率在前2小时为11.5%±2.2%，接下来2小时仅为3.4%±0.5%，这是由于组织摄取使哇巴因从细胞外液室快速清除所致。因此，血液透析对于减少体内哇巴因储存相对无效。慢性肾衰竭患者中哇巴因的消除明显慢于正常受试者（P<0.01），但明显快于慢性肾衰竭患者中地高辛（P<0.01）和洋地黄毒苷（P<0.01）的报告值，这在治疗此类患者的急性心脏问题中可能是一个有用的特征。