Winslow R M
Department of Medicine, School of Medicine, University of California at San Diego, La Jolla 92161, USA.
Annu Rev Med. 1999;50:337-53. doi: 10.1146/annurev.med.50.1.337.
Red cell substitutes are solutions that can potentially be used in emergencies or during surgery when rapid expansion of the blood volume with an oxygen carrier is needed. The three main types of products in development are based on cell-free hemoglobin, perfluorocarbon emulsions, or liposome-encapsulated hemoglobin. None is currently approved for clinical use, but several are in advanced clinical trials. Outside the red blood cell, hemoglobin is subject to degradation and heme loss. It readily diffuses in the plasma space and effectively scavenges nitric oxide. These properties must be understood and controlled if hemoglobin-based products are to fulfill their promise. The development of red cell substitutes affords us a deeper insight into how oxygen is delivered to tissues in the microcirculation and how blood-flow distribution is regulated within and between organs. As red cell substitutes become available to clinicians and scientists, clinical applications are expected to expand.
红细胞替代物是在紧急情况或手术期间，当需要用氧载体快速扩充血容量时可能会用到的溶液。目前正在研发的三种主要产品类型基于无细胞血红蛋白、全氟碳乳液或脂质体包裹的血红蛋白。目前尚无一种产品获批用于临床，但有几种正处于高级临床试验阶段。在红细胞之外，血红蛋白会发生降解并失去血红素。它很容易在血浆空间中扩散，并有效清除一氧化氮。如果基于血红蛋白的产品要实现其前景，就必须了解并控制这些特性。红细胞替代物的研发让我们更深入地了解氧气如何在微循环中输送到组织，以及器官内部和之间的血流分布是如何调节的。随着临床医生和科学家能够使用红细胞替代物，预计临床应用将会扩大。
