肾衰竭时的跨毛细血管胶体渗透压梯度与体液容量

Transcapillary colloid osmotic gradient and body fluid volumes in renal failure.

作者信息

Fauchald P

出版信息

Kidney Int. 1986 Apr;29(4):895-900. doi: 10.1038/ki.1986.83.

DOI:10.1038/ki.1986.83

Abstract

The aim was to study the transcapillary fluid balance in dialysis patients during and after ultrafiltration. Plasma and subcutaneous interstitial fluid (wick technique) colloid osmotic pressure, plasma volume (I125-albumin space) and extracellular fluid volume (radiosulfate space) were measured in nine patients on maintenance hemodialysis before (pre-dialysis state) and after (dry-weight state) ultrafiltration. In the pre-dialysis state, interstitial colloid osmotic pressure was reduced compared to normal controls (12.7 +/- 3.5 versus 15.8 +/- 2.7 mmHg, mean values +/- SD) and transcapillary colloid osmotic gradient increased (15.3 +/- 3.0 versus 12.8 +/- 2.7 mmHg). Ultrafiltration resulted in a parallel decrease of plasma volume and interstitial fluid volume of 19 to 20%, and an increase in mean interstitial colloid osmotic pressure of 3.4 mmHg and in mean transcapillary colloid osmotic gradient of 1.9 mmHg. The mean ultrafiltration rate was 21.9 +/- 1.9 ml/min and the plasma refilling rate was 16.5 +/- 2.7 ml/min. It is concluded that the changes in plasma and interstitial fluid colloid osmotic pressure tend to preserve plasma volume and limit the interdialytic increase in interstitial fluid volume.

摘要

目的是研究透析患者超滤期间及超滤后的跨毛细血管液体平衡。对9例维持性血液透析患者在超滤前（透析前状态）和超滤后（干体重状态）测量血浆和皮下组织间液（灯芯技术）胶体渗透压、血浆容量（I125-白蛋白空间）和细胞外液容量（放射性硫酸盐空间）。在透析前状态，与正常对照组相比，组织间胶体渗透压降低（分别为12.7±3.5 mmHg和15.8±2.7 mmHg，均值±标准差），跨毛细血管胶体渗透压梯度增加（分别为15.3±3.0 mmHg和12.8±2.7 mmHg）。超滤导致血浆容量和组织间液容量平行减少19%至20%，平均组织间胶体渗透压升高3.4 mmHg，平均跨毛细血管胶体渗透压梯度升高1.9 mmHg。平均超滤率为21.9±1.9 ml/min，血浆再充盈率为16.5±2.7 ml/min。结论是血浆和组织间液胶体渗透压的变化倾向于维持血浆容量并限制透析间期组织间液容量的增加。