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持续性非卧床腹膜透析患者红细胞的氧亲和力及肺气体交换

Oxygen affinity of erythrocytes and pulmonary gas exchange in patients on continuous ambulatory peritoneal dialysis.

作者信息

Blumberg A, Keller R, Marti H R

出版信息

Nephron. 1984;38(4):248-52. doi: 10.1159/000183317.

Abstract

In 11 patients on continuous ambulatory peritoneal dialysis 2,3-diphosphoglycerate, oxygen (O2) affinity of red cells (P50), blood gases, ventilation, and O2 consumption were studied. Contrary to patients on maintenance hemodialysis, 2,3-diphosphoglycerate and P50 were normal in patients on continuous ambulatory peritoneal dialysis; they were correlated with each other. Arterial O2 pressure was normal; under the conditions of dialysis with 35 mmol lactate per liter dialysis fluid a slight metabolic acidosis persisted; it was combined with a moderate respiratory alkalosis. Position had no influence upon pulmonary gas exchange with the exception of the alveolo-arterial gradient which was elevated when the abdominal cavity was filled with dialysis fluid and the patients assumed the supine position. Ventilation was in the normal range, whereas O2 consumption was low, possibly due to a reduction in muscle mass in some of the patients. It is concluded that pulmonary gas exchange and erythrocyte O2 transport were normal and that O2 requirements tended to be low in this group of patients on continuous ambulatory peritoneal dialysis.

摘要

对11例持续性非卧床腹膜透析患者的2,3-二磷酸甘油酸、红细胞氧(O2)亲和力(P50)、血气、通气及氧消耗进行了研究。与维持性血液透析患者不同,持续性非卧床腹膜透析患者的2,3-二磷酸甘油酸和P50正常,且二者相互关联。动脉血氧分压正常;在使用每升含35 mmol乳酸盐的透析液进行透析的情况下,轻微的代谢性酸中毒持续存在,且伴有中度呼吸性碱中毒。除肺泡-动脉氧分压差外,体位对肺气体交换无影响,当腹腔充满透析液且患者取仰卧位时,肺泡-动脉氧分压差升高。通气在正常范围内,而氧消耗较低,这可能是由于部分患者肌肉量减少所致。得出的结论是,在这组持续性非卧床腹膜透析患者中,肺气体交换和红细胞氧运输正常,且氧需求往往较低。

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