de Groot G, van Heijst A N, van Kesteren R G, Maes R A
Arch Toxicol. 1985 Apr;57(1):61-6. doi: 10.1007/BF00286577.
The efficacy of intermittent charcoal haemoperfusion in combination with forced diuresis and Prussian blue therapy was evaluated in three cases of thallium poisoning. At a blood flow of 300 ml/min the average blood clearance values obtained with haemoperfusion were 72 +/- 11 ml/min (mean +/- SD) at a starting blood concentration above 2 mg/l and 120 +/- 23 ml/min (mean +/- SD) below this blood level. As a result of the combined intensive treatment, the thallium half-lives in blood observed during the period monitored were only 25-41 h. Removal of thallium by haemoperfusion is faster per unit of time than simultaneous excretion by forced diuresis. When forced diuresis was combined with intermittent (4-20 h intervals) haemoperfusion therapy, the total elimination by each technique was about equivalent over the period of combined treatment. Saturation of the Adsorba 300 C columns occurred during treatment. As a result, the clearance obtained did decrease to half the initial value in 2-3 h. As this decrease in efficacy is related to the blood concentration, haemoperfusion is more efficient at lower blood concentrations. This is in contradistinction to forced diuresis, of which the excretion is proportional to the blood concentration.
对3例铊中毒患者评估了间歇性血液灌流联合强制利尿及普鲁士蓝疗法的疗效。在血流速度为300 ml/min时，血液灌流在起始血浓度高于2 mg/l时获得的平均血液清除率为72±11 ml/min（均值±标准差），低于此血浓度时为120±23 ml/min（均值±标准差）。由于联合强化治疗，在监测期间观察到的血液中铊的半衰期仅为25 - 41小时。血液灌流每单位时间内清除铊的速度比同时进行的强制利尿排泄更快。当强制利尿与间歇性（间隔4 - 20小时）血液灌流疗法联合使用时，在联合治疗期间每种技术的总清除量大致相当。治疗期间吸附柱（Adsorba 300 C）出现饱和。结果，所获得的清除率在2 - 3小时内确实降至初始值的一半。由于这种疗效降低与血浓度有关，血液灌流在较低血浓度时更有效。这与强制利尿相反，强制利尿的排泄与血浓度成正比。
