Maher J F, Shea C, Cassetta M, Hohnadel D C
J Dial. 1977;1(4):319-31. doi: 10.3109/08860227709038423.
As peritoneal dialysis is inefficient enouth to be time-consuming and sometimes clinically ineffective, we have evaluated pharmacologic enhancement of peritoneal permeability. Peritoneal dialyses were performed in New Zealand white rabbits by instillation of 50 ml/Kg of isotonic dialysis solution of standard composition. Mean peritoneal clearance of creatinine was 0.60 ml/Kg/min and urea was 0.80 ml/Kg/min, each decreasing as intraperitoneal dwell was prolonged (by .011 ml/Kg/min or less). With 0.04 micrometer/Kg of isoproterenol administered intraperitoneally, clearances increased to 0.91 and 1.30 ml/Kg/min (p less than 0.01). When isoproterenol was added to the dialysis solution one hour or more before instillation, the increment in clearances was less. Instillation of dialysis solution 24 hours after addition of a higher dose of isoproterenol (0.2 micrometer/Kg) did not increase clearances above control. No effect of isoproterenol on bulk flow of water, associated with the osmotic effect of dextrose, was demonstrated. As peritoneal clearances increased, the ratio creatinine clearance: urea clearance did not decrease, consistent with increased peritoneal permeability as well as blood flow.
由于腹膜透析效率低下，耗时较长，有时在临床上效果不佳，我们评估了药物对腹膜通透性的增强作用。通过向新西兰白兔腹腔内注入50 ml/kg标准成分的等渗透析液来进行腹膜透析。肌酐的平均腹膜清除率为0.60 ml/kg/min，尿素为0.80 ml/kg/min，随着腹腔内停留时间延长（每分钟减少0.011 ml/kg/min或更少），两者清除率均下降。腹腔内给予0.04微克/千克异丙肾上腺素后，清除率分别增至0.91和1.30 ml/kg/min（p<0.01）。在注入前1小时或更长时间将异丙肾上腺素加入透析液中，清除率的增加幅度较小。在加入较高剂量的异丙肾上腺素（0.2微克/千克）24小时后注入透析液，清除率并未高于对照组。未证明异丙肾上腺素对与葡萄糖渗透作用相关的水的大量流动有影响。随着腹膜清除率增加，肌酐清除率与尿素清除率的比值并未降低，这与腹膜通透性及血流量增加一致。
