Struijk D G, Krediet R T, Koomen G C, Boeschoten E W, vd Reijden H J, Arisz L
Foundation for Home Dialysis, Midden-West Nederland, Amsterdam.
Perit Dial Int. 1990;10(2):141-5.
To elucidate the importance of possible trapping of macromolecules in peritoneal tissue on the calculation of peritoneal lymphatic drainage, we compared the transport of inulin administered i.v. and i.p. in nine continuous ambulatory peritoneal dialysis (CAPD) patients on two separate days. In the intraperitoneal study inulin (5 g) was added to the dialysate and in the intravenous study inulin (5 g) was given i.v. 3 h before the test. No differences were found in the mass transfer area coefficients (MTC) of urea, creatinine, and glucose between the two tests. The MTC after inulin i.p. was 3.2 +/- 0.7 mL/min (mean +/- SD) and after inulin i.v. 1.8 +/- 0.5 (p less than 10(-5]. As the difference in transport kinetics between i.v. and i.p. administration is likely to be caused by lymphatic absorption, a mean lymphatic flow of 1.4 mL/min could be calculated. This value corresponds to the data obtained with macromolecules. Our results therefore favor the hypothesis that no local accumulation of macromolecules in the peritoneal tissues takes place and that their disappearance from the peritoneal cavity represents lymphatic absorption.
为阐明腹膜组织中大分子物质的可能截留对腹膜淋巴引流计算的重要性，我们在9例持续性非卧床腹膜透析（CAPD）患者的两个不同日期，比较了静脉注射和腹腔内注射菊粉后的转运情况。在腹腔内研究中，将菊粉（5 g）加入透析液中；在静脉内研究中，在试验前3小时静脉注射菊粉（5 g）。两项试验中尿素、肌酐和葡萄糖的传质面积系数（MTC）未发现差异。腹腔内注射菊粉后的MTC为3.2±0.7 mL/分钟（平均值±标准差），静脉注射菊粉后为1.8±0.5（p<10^(-5)）。由于静脉注射和腹腔内注射给药之间转运动力学的差异可能是由淋巴吸收引起的，因此可以计算出平均淋巴流量为1.4 mL/分钟。该值与大分子物质获得的数据一致。因此，我们的结果支持以下假设：腹膜组织中不会发生大分子物质的局部蓄积，它们从腹膜腔中的消失代表淋巴吸收。
