Soliani F, Davoli V, Franco V, Lindner G, Lusenti T, Parisoli A, Brini M, Borgatti P P
Division of Nephrology, Hospital S. Maria Nuova, Reggio Emilia, Italy.
Nephrol Dial Transplant. 1990;5 Suppl 1:119-21. doi: 10.1093/ndt/5.suppl_1.119.
In nine chronic haemodialysis patients, treated alternately with acetate and bicarbonate, the main critical factors in oxygen supply to the tissues were evaluated: Hb values, blood gas parameters, red cell 2-3 diphosphoglycerate (2-3 DPG), phosphataemia and P50 in vivo. Predialytic P50 was higher than in normal controls. During dialysis, arterial pO2 and pCO2 significantly decreased in acetate dialysis, whereas they were stable in bicarbonate dialysis. Rising alkalinisation was accompanied, both in acetate dialysis and in bicarbonate dialysis, by reduction of P50, while 2-3 DPG did not change. The acute increase in Hb-O2 affinity adversely affected peripheral oxygen release. In acetate dialysis this mechanism might magnify the effects of dialysis-induced hypoxaemia, affecting the clinical tolerance.
在9名交替接受醋酸盐和碳酸氢盐治疗的慢性血液透析患者中，对组织氧供应的主要关键因素进行了评估：血红蛋白值、血气参数、红细胞2,3-二磷酸甘油酸（2,3-DPG）、血磷水平和体内P50。透析前P50高于正常对照组。透析期间，醋酸盐透析时动脉血氧分压（pO2）和二氧化碳分压（pCO2）显著下降，而在碳酸氢盐透析时则保持稳定。在醋酸盐透析和碳酸氢盐透析中，随着碱化程度的增加，P50均降低，而2,3-DPG不变。血红蛋白与氧气亲和力的急性增加对周围组织氧释放产生不利影响。在醋酸盐透析中，这种机制可能会放大透析诱导的低氧血症的影响，从而影响临床耐受性。
