Wright R R, Tono M, Pollycove M
Semin Nucl Med. 1975 Jan;5(1):63-78. doi: 10.1016/s0001-2998(75)80005-5.
During the past decade the diagnostic use of blood volume determinations has declined as a result of the generation of largely inaccurate results and inappropriate normalization and interpretation. After historical development of more than 50 years, current methodology employs 125I-labeled human serum albumin and 51Cr-labeled red blood cells to determine plasma volume and red cell volume, respectively. Accurate blood volume determinations require (1) abandoning the use of the mean body hematocrit:venous hematocrit ratio and using simultaneous independent measurements of both volumes; (2) delaying multiple postinjection patient samples until complete mixing and equilibration are complete; (3) backextrapolation of plasma concentrations of 125I to account for albumin loss from the plasma, and, rarely, back-extrapolation of red cell concentrations to account for dilution by red cells transfused during the procedure; (4) normalization of volumes by adjusting patient weight to normal correspondence with lean tissue mass, whenever necessary. A rapid, routine method that fulfills these four requirements is presented. A number of surgical and medical conditions in which blood volume determinations are very useful in diagnosis and therapy are discussed. Recently developed techniques for blood volume measurements include neutron acativation analysis and fluorescent excitation analysis. Correct normalization of accurate blood volume measurements will provide a valuable service to the entire medical community.
在过去十年中，由于产生的结果大多不准确以及标准化和解释不当，血容量测定的诊断用途有所下降。经过50多年的历史发展，目前的方法分别采用125I标记的人血清白蛋白和51Cr标记的红细胞来测定血浆容量和红细胞容量。准确的血容量测定需要：（1）摒弃使用平均体血细胞比容：静脉血细胞比容比值，采用同时独立测量两种容量的方法；（2）延迟多次注射后采集患者样本，直到完全混合和平衡完成；（3）对125I的血浆浓度进行反向外推，以考虑血浆中白蛋白的损失，很少情况下，对红细胞浓度进行反向外推，以考虑在该过程中输入的红细胞引起的稀释；（4）必要时，通过调整患者体重使其与瘦组织质量正常对应来对容量进行标准化。本文介绍了一种满足这四个要求的快速常规方法。讨论了一些血容量测定在诊断和治疗中非常有用的外科和内科疾病。最近开发的血容量测量技术包括中子活化分析和荧光激发分析。准确血容量测量的正确标准化将为整个医学界提供有价值的服务。
