Crane G G, Wells J V, Jones P
Trans R Soc Trop Med Hyg. 1975;69(2):212-20. doi: 10.1016/0035-9203(75)90158-3.
The effect of alterations in serum protein levels on plasma volume in tropical splenomegaly syndrome has been investigated by determining plasma volume, serum albumin, globulin and immunoglobulin levels in 64 adult New Guineans suffering from this disease. Plasma volumes ranged from 51-2 to 129 ml./kg. Significant positive correlations were found between plasma volume and intravascular pools of albumin, IgG and IgM. Multiple regression analysis demonstrated that 70% of the variance in plasma volume in this series was attributable to increases in these three pools, IgM and IgG accounting for 42% of the total and albumin for 28%. It is probable that the unexplained 30% of plasma volume expansion arises through a splenic arterio-venous shunt effect. It is suggested that initially in tropical splenomegaly syndrome the splenic shunt and immunoglobulin overproduction combine to produce expansion of plasma volume and a fall in intravascular colloid osmotic pressure; that the latter provides the stimulus to increased albumin synthesis, and that this further aggravates the plasma volume expansion and the consequent dilutional anaemia commonly seen in this disease.
通过测定64名患有热带脾肿大综合征的成年新几内亚人的血浆容量、血清白蛋白、球蛋白和免疫球蛋白水平，研究了血清蛋白水平改变对该疾病血浆容量的影响。血浆容量范围为51.2至129毫升/千克。血浆容量与白蛋白、IgG和IgM的血管内池之间存在显著正相关。多元回归分析表明，该系列中血浆容量变化的70%可归因于这三个池的增加，IgM和IgG占总量的42%，白蛋白占28%。血浆容量扩张中无法解释的30%可能是通过脾动静脉分流效应产生的。有人提出，在热带脾肿大综合征初期，脾分流和免疫球蛋白过度产生共同作用，导致血浆容量扩张和血管内胶体渗透压下降；后者刺激白蛋白合成增加，进而进一步加重血浆容量扩张以及该疾病中常见的稀释性贫血。
