Gouyon J B, Semama D, Prévot A, Desgres J
Laboratoire de Néphrolgie-Hémaphérèse-Transplantation, Hôpital d'Enfants, Centre Hospitalier Universitaire, Dijon, France.
J Inherit Metab Dis. 1996;19(5):610-20. doi: 10.1007/BF01799834.
Venovenous haemofiltration (VVHF) and haemodiafiltration (VVHDF) were performed with a neonatal haemo(dia)filter (Miniflow 10, Hospal) on 8 anaesthetized rabbits infused with branched-chain amino acids (leucine, isoleucine and valine) and alpha-ketoisocaproate. The branched-chain amino acids (BCAA) and alpha-ketoisocaproate blood levels were close to those previously observed in neonates with maple syrup urine disease when extracorporeal blood purification was required. VVHF and VVHDF performances were assessed with two different blood flows (Qb = 8.3 and 16.6 ml/min). VVHDF was performed with four dialysate flow rates (Qd = 0.5, 1.0, 2.0 and 3.0 L/h). Within each period, clearances of the three BCAA were strictly similar. BCAA clearances obtained by VVHF were similar to ultrafiltration rates (respectively, 0.78 +/- 0.14 and 1.79 +/- 0.28 ml/min at high and low Qb; p < 0.05). The alpha-ketoisocaproate clearances obtained by VVHF were 0.39 +/- 0.17 and 0.92 +/- 0.43 ml/min at low and high Qb (not significantly different). Whatever the Qd value, the VVHDF procedures always allowed higher BCAA and alpha-ketoisocaproate clearances as compared with the corresponding VVHF period with similar Qb. BCAA clearances obtained by VVHDF with a 0.5 L/h dialysate flow were 4.1 +/- 0.5 and 5.4 +/- 0.5 mL/min at low and high Qb, respectively. The concurrent alpha-ketoisocaproate clearances were 2.5 +/- 0.8 and 2.9 +/- 1.0 ml/min.
对8只输注支链氨基酸（亮氨酸、异亮氨酸和缬氨酸）和α-酮异己酸的麻醉兔，使用新生儿血液（透析）滤过器（Miniflow 10，Hospal）进行静脉-静脉血液滤过（VVHF）和血液透析滤过（VVHDF）。支链氨基酸（BCAA）和α-酮异己酸的血药浓度与先前观察到的需要进行体外血液净化的枫糖尿症新生儿的血药浓度相近。采用两种不同的血流量（Qb = 8.3和16.6 ml/min）评估VVHF和VVHDF的性能。VVHDF采用四种透析液流速（Qd = 0.5、1.0、2.0和3.0 L/h）。在每个时间段内，三种BCAA的清除率严格相似。VVHF获得的BCAA清除率与超滤率相似（高Qb和低Qb时分别为0.78±0.14和1.79±0.28 ml/min；p<0.05）。VVHF获得的α-酮异己酸清除率在低Qb和高Qb时分别为0.39±0.17和0.92±0.43 ml/min（无显著差异）。无论Qd值如何，与具有相似Qb的相应VVHF时间段相比，VVHDF程序始终能实现更高的BCAA和α-酮异己酸清除率。在低Qb和高Qb时，透析液流速为0.5 L/h的VVHDF获得的BCAA清除率分别为4.1±0.5和5.4±0.5 mL/min。同时的α-酮异己酸清除率为2.5±0.8和2.9±1.0 ml/min。
