Mansell M A, Crowther A, Laker M F, Wing A J
Clin Nephrol. 1982 Sep;18(3):130-4.
We used impedance cardiography to monitor changes in cardiac output in 22 adult patients with terminal renal failure during hemodialysis against a dialyzate containing acetate. In 7 patients arterial acetate levels rose progressively during dialysis while in the remainder they remained low and steady. Patients who developed hyperacetatemia were able to maintain an elevated cardiac output during dialysis in contrast to the patients with stable acetate levels in whom cardiac output fell. These results strengthen our previous conclusion that acetate as used in conventional regular hemodialysis does not have a cardiodepressant action. The reported benefits of bicarbonate dialysis therefore involve other factors.
我们采用阻抗心动描记术监测了22例终末期肾衰竭成年患者在使用含醋酸盐透析液进行血液透析期间的心输出量变化。7例患者在透析过程中动脉血醋酸盐水平逐渐升高，而其余患者的水平则保持低且稳定。与醋酸盐水平稳定且心输出量下降的患者相比，发生高醋酸血症的患者在透析期间能够维持较高的心输出量。这些结果强化了我们之前的结论，即常规规律血液透析中使用的醋酸盐没有心脏抑制作用。因此，报道的碳酸氢盐透析的益处涉及其他因素。
