Pollack G M, Buchanan J F, Slaughter R L, Kohli R K, Shen D D
Toxicol Appl Pharmacol. 1985 Jun 30;79(2):257-67. doi: 10.1016/0041-008x(85)90347-3.
The degree of exposure to the plasticizer di(2-ethylhexyl) phthalate (DEHP) was assessed in 11 patients undergoing maintenance hemodialysis for the treatment of renal failure. The amount of DEHP leached from the dialyzer during a 4-hr dialysis session was estimated by monitoring the DEHP blood concentration gradient across the dialyzer. Circulating concentrations of the biologically active products of DEHP de-esterification, viz., mono(2-ethylhexyl) phthalate (MEHP) and phthalic acid, were also determined during the dialysis session. On the average, an estimated 105 mg of DEHP was extracted from the dialyzer during a single dialysis session, with a range of 23.8 to 360 mg. The rate of extraction of DEHP from the dialyzer was correlated with serum lipid content as expressed by the sum of serum cholesterol and triglyceride concentrations (r = +0.65, p less than 0.05). Time-averaged circulating concentrations of MEHP during dialysis (1.33 +/- 0.58 micrograms/ml) were similar to those of DEHP (1.91 +/- 2.11 micrograms/ml). Blood concentrations of phthalic acid (5.22 +/- 3.94 micrograms/ml) were higher than those of the esters. The length of time patients had been receiving regular dialysis treatment was not a determinant of circulating concentrations of DEHP or MEHP. In contrast, time-averaged circulating concentrations of phthalic acid correlated strongly with the duration (in years) of dialysis treatment (r = +0.92, p less than 0.001). The results indicated substantial exposure to DEHP during hemodialysis and that the de-esterified products of DEHP are present in significant concentrations in the systemic circulation. Further study is needed to assess the contribution of these metabolites to the biological actions of DEHP in man.
对11名接受维持性血液透析治疗肾衰竭的患者的邻苯二甲酸二（2-乙基己基）酯（DEHP）暴露程度进行了评估。通过监测透析器两端的DEHP血药浓度梯度，估算了4小时透析过程中透析器中DEHP的析出量。在透析过程中还测定了DEHP去酯化生物活性产物，即邻苯二甲酸单（2-乙基己基）酯（MEHP）和邻苯二甲酸的循环浓度。单次透析过程中，平均从透析器中提取出约105mg的DEHP，范围为23.8至360mg。透析器中DEHP的提取率与血清脂质含量相关，以血清胆固醇和甘油三酯浓度之和表示（r = +0.65，p < 0.05）。透析期间MEHP的时间平均循环浓度（1.33±0.58μg/ml）与DEHP的浓度（1.91±2.11μg/ml）相似。邻苯二甲酸的血药浓度（5.22±3.94μg/ml）高于其酯类。患者接受定期透析治疗的时间长短不是DEHP或MEHP循环浓度的决定因素。相比之下，邻苯二甲酸的时间平均循环浓度与透析治疗时间（年）密切相关（r = +0.92，p < 0.001）。结果表明血液透析期间患者大量暴露于DEHP，且DEHP的去酯化产物在体循环中大量存在。需要进一步研究以评估这些代谢产物对DEHP在人体生物学作用中的贡献。
