Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3, Aramaki-aza-aoba, Aobaku, Sendai 980-8578, Japan.
Magn Reson Med Sci. 2013;12(2):129-35. doi: 10.2463/mrms.2012-0076. Epub 2013 May 10.
We used ¹H nuclear magnetic resonance (NMR) spectroscopy to assess metabolic responses in patients undergoing hemodialysis (HD). We collected 71 samples of plasma and dialysate from 10 patients before, during, and after HD. We used the dialysate as a possible substitute for blood plasma to quantify small metabolites by ¹H NMR. We confirmed TSP (sodium 3-(trimethylsilyl) propionate 2, 2, 3, 3-d4) as a reference of NMR intensity in dialysate. We examined TSP sensitivities in various dialysate spectra and the correlation between signal intensities and added quantities of TSP. We used integrations of signal areas on ¹H NMR spectra of plasma and dialysate to quantify concentrations of creatinine, lactate, alanine, and valine and calculate their ratios between plasma and dialysate. The ratios of metabolites in plasma to dialysate were 3.2±0.4 (creatinine), 3.6±0.5 (valine), 3.8±0.7 (alanine), and 4.0±0.8 (lactate) mM (mean±standard deviation [SD]). The broader distributions of ratios in levels of lactate and alanine suggested their de novo production during the HD session. Estimation of blood metabolite levels using dialysate is useful for quantitative analysis of metabolic status in blood during HD.
我们使用 ¹H 核磁共振（NMR）光谱来评估接受血液透析（HD）的患者的代谢反应。我们从 10 名患者的血液和透析液中收集了 71 个样本，分别在 HD 之前、期间和之后进行。我们使用透析液作为血液的可能替代品，通过 ¹H NMR 定量分析小代谢物。我们通过确认 TSP（3-（三甲基硅基）丙酸钠 2,2,3,3-d4）作为 NMR 强度在透析液中的参考物来验证这一点。我们研究了不同透析液谱中 TSP 灵敏度以及信号强度与添加 TSP 量之间的相关性。我们使用血浆和透析液的 ¹H NMR 光谱上的信号区域积分来定量肌酐、乳酸、丙氨酸和缬氨酸的浓度，并计算它们在血浆和透析液之间的比值。血浆与透析液中代谢物的比值分别为 3.2±0.4（肌酐）、3.6±0.5（缬氨酸）、3.8±0.7（丙氨酸）和 4.0±0.8（乳酸）mM（平均值±标准偏差 [SD]）。乳酸和丙氨酸水平比值的分布范围较宽，表明它们在 HD 期间有新的生成。使用透析液估计血液代谢物水平可用于在 HD 期间对血液代谢状态进行定量分析。
