Botella J, Traver J A, Sanz-Guajardo D, Torres M T, Sanjuan I, Zabala P
Proc Eur Dial Transplant Assoc. 1977;14:192-9.
In two dialysis centres in the same city, with a total of 56 patients on regular dialysis treatment, it has been shown that the tap water used for the production of the dialysate contains chloramines. Total chlorine concentration and percentage of chloramines varies from 0.5 to 1.1 ppm and from 40 to 95 per cent. There in a high percentage of Heinz bodies in the patients' erythrocytes, and incubation of red cells in vitro with the dialysate raises the methaemoglobin concentration and alters the hexose-monophosphate shunt. The patients' mean haematocrit improved from 23.13 +/- 4.41 SD to 25.93 +/- 5.17 SD (p less than 0.0025) with the administration of ascorbic acid, 500 mg given intravenously once a week, but an unexpected transitory increase of the total chlorine to 3.5 ppm resulted in a serious decline of the mean haematocrit to 20.80 +/- 5.22 SD (p less than 0.0001). Ascorbic acid added to the dialysate at a concentration of 1.7 mg/dl produced a great improvement in the anaemia and the almost total disappearance of Heinz bodies from the patients' red cells.
在同一城市的两个透析中心，共有56名患者接受定期透析治疗。结果显示，用于制备透析液的自来水中含有氯胺。总氯浓度和氯胺百分比在0.5至1.1 ppm以及40%至95%之间变化。患者红细胞中出现高比例的海因茨小体，且红细胞在体外与透析液孵育会提高高铁血红蛋白浓度并改变磷酸己糖旁路。通过每周静脉注射一次500毫克抗坏血酸，患者的平均血细胞比容从23.13±4.41标准差提高到25.93±5.17标准差（p＜0.0025），但总氯意外短暂升高至3.5 ppm导致平均血细胞比容严重下降至20.80±5.22标准差（p＜0.0001）。向透析液中添加浓度为1.7毫克/分升的抗坏血酸，可使贫血状况大为改善，且患者红细胞中的海因茨小体几乎完全消失。
