Entholzner E K, Mielke L L, Calatzis A N, Feyh J, Hipp R, Hargasser S R
Arbeitsgruppe Hämostaseologie, Technische Universität München, Klinikum rechts der Isar, Germany.
Acta Anaesthesiol Scand. 2000 Oct;44(9):1116-21. doi: 10.1034/j.1399-6576.2000.440914.x.
Hydroxyethyl starches (HES) are known to interfere with blood coagulation according to molecular weight, the degree of substitution and the C2/C6 ratio. A recently developed low molecular hydroxyethyl starch (HES 130/0.4) was designed to reduce the blood compromising potency.
In this study, effects of a 30% in vitro haemodilution with the new HES preparation (HES 130/0.4) in comparison to HES 200/0.5, HES 450/0.7 and sodium chloride solution were investigated using intrinsic and extrinsic activated thrombelastography (TEG) and plasmatic coagulation tests.
Whereas plasmatic tests revealed no prolongation of coagulation by HES in comparison to sodium chloride, the TEG variables clotting time, clot formation time and maximal clot firmness showed a significant (P<0.05) inhibition by all the HES preparations. The inhibition was most pronounced in HES 450 (P<0.05 vs HES 130) while HES 130 did not show a statistically significant difference in extrinsic activated maximal clot firmness when compared to sodium chloride.
These in vitro results demonstrate that hydroxythyl starches especially compromise clot polymerisation. The new preparation HES 130/0.4 seems to inhibit platelet function to a lesser extent than hydroxyethyl starch preparations with a higher molecular weight and degree of substitution.
已知羟乙基淀粉（HES）会根据分子量、取代度和C2/C6比例干扰血液凝固。最近开发的低分子羟乙基淀粉（HES 130/0.4）旨在降低对血液的损害作用。
在本研究中，使用内源性和外源性激活血栓弹力图（TEG）以及血浆凝血试验，研究了用新型HES制剂（HES 130/0.4）进行30%体外血液稀释与HES 200/0.5、HES 450/0.7和氯化钠溶液相比的效果。
与氯化钠相比，血浆试验显示HES不会延长凝血时间，但TEG变量凝血时间、血块形成时间和最大血块硬度显示所有HES制剂均有显著（P<0.05）抑制作用。HES 450的抑制作用最为明显（与HES 130相比，P<0.05），而与氯化钠相比时，HES 130在外源性激活最大血块硬度方面未显示出统计学上的显著差异。
这些体外结果表明，羟乙基淀粉尤其会损害血块聚合作用。新型制剂HES 130/0.4似乎比具有更高分子量和取代度的羟乙基淀粉制剂对血小板功能的抑制作用更小。
