Newstead C G
Department of Nephrology, London Hospital (Whitechapel), UK.
Nephrol Dial Transplant. 1989;4(7):658-61.
In four normal subjects a 50-cm segment of the jejunum was perfused through a multilumen tube with either hypertonic (1300 mOsm/kg) or isotonic mixtures of mannitol and water at rates between 18 and 70 ml/min. There was no difference in the solute clearances produced by the two solutions. Mean clearances (ml/min) were urea 23, creatinine 8, urate 4. Ninety-five mmol of sodium and 3.8 mmol of potassium were removed during a 1-h perfusion period. Clearances of glucose, calcium, phosphate and protein were negligible. Mean free water clearance was 0.5 ml/min during isotonic perfusion and 22.4 ml/min during hypertonic perfusion. These clearances of urea and creatinine are similar to those previously reported during perfusion of the whole bowel in uraemic patients with isotonic mannitol and during segmental jejunal perfusion with glucose/sodium mixtures. Over the range of flow rates studied there was a positive linear relationship between perfusate flow rates might achieve clinically useful solute clearance. However, the efficacy of the method in prolonged perfusion of uraemic patients may be different from that seen in normal subjects.
在4名正常受试者中，通过多腔管以18至70 ml/min的速率用高渗（1300 mOsm/kg）或甘露醇与水的等渗混合物灌注空肠的50 cm节段。两种溶液产生的溶质清除率没有差异。平均清除率（ml/min）分别为尿素23、肌酐8、尿酸盐4。在1小时的灌注期内，清除了95 mmol的钠和3.8 mmol的钾。葡萄糖、钙、磷酸盐和蛋白质的清除率可忽略不计。等渗灌注期间平均自由水清除率为0.5 ml/min，高渗灌注期间为22.4 ml/min。这些尿素和肌酐的清除率与先前报道的尿毒症患者用等渗甘露醇进行全肠灌注以及用葡萄糖/钠混合物进行空肠节段灌注时的清除率相似。在所研究的流速范围内，灌注液流速之间存在正线性关系，可能实现临床上有用的溶质清除。然而，该方法在尿毒症患者长时间灌注中的效果可能与在正常受试者中观察到的不同。
