Marangoni R, Civardi F, Masi F, Savino R, Cimino R, Colombo R, Maltagliati L
Nephrology and Dialysis Unit, Ospedale Caduti Bollatesi, Bollate, Italy.
Artif Organs. 1995 Jun;19(6):490-5. doi: 10.1111/j.1525-1594.1995.tb02367.x.
In this study, 6 chronic anuric uremic patients underwent lactate hemofiltration (HF) with a substitution fluid, prepared in bags, for 3 months and bicarbonate HF, with continuous on-line preparation of the substitution fluid, for 3 months. We determined Na+, Cl-, K+, total calcium (Ca), ionized calcium (Ca2+), phosphate, intact parathormone (I-PTH), pH, PCO2, PO2, and HCO3- in plasma before, during, and after the treatment, as well as Ca, Ca2+, phosphate, and I-PTH in the ultrafiltrate. Moreover, heart rate (HR) and mean arterial pressure (MAP) were continually recorded during the procedure. Furthermore, the patients underwent echocardiographic study before and after the session. In comparison with lactate, bicarbonate HF caused a significant increase in HCO3- and a decrease in K+ plasma concentrations. This was detectable, with lower significance, even 44 h after the end of the treatment. At the end of the long interdialytic period (68 h after the end of the treatment), no significant difference was detectable. pH and PCO2 showed a significant but transient increase during HF. The other parameters investigated did not differ significantly between the two methods.
在本研究中，6例慢性无尿尿毒症患者接受了为期3个月的乳酸盐血液滤过（HF）治疗，置换液采用袋装制备；以及为期3个月的碳酸氢盐HF治疗，置换液采用持续在线制备。我们测定了治疗前、治疗期间和治疗后的血浆中Na+、Cl-、K+、总钙（Ca）、离子钙（Ca2+）、磷酸盐、完整甲状旁腺激素（I-PTH）、pH、PCO2、PO2和HCO3-，以及超滤液中的Ca、Ca2+、磷酸盐和I-PTH。此外，在治疗过程中持续记录心率（HR）和平均动脉压（MAP）。此外，患者在治疗前后接受了超声心动图检查。与乳酸盐相比，碳酸氢盐HF导致HCO3-显著增加，血浆K+浓度降低。即使在治疗结束后44小时，这种变化仍可检测到，但显著性较低。在长时间透析间期结束时（治疗结束后68小时），未检测到显著差异。HF期间pH和PCO2显著但短暂升高。两种方法之间，其他所研究的参数没有显著差异。
