Staedt U, Holm E, Leweling H, Heene D L
Klinikum Mannheim, Universität Heidelberg, Germany.
Neurol Res. 1992;14(2 Suppl):152-5. doi: 10.1080/01616412.1992.11740038.
In a prospective study we randomly allocated 50 patients with acute ischaemic stroke in the area of the middle cerebral artery within 12 hours after onset to two moderate hypervolemic haemodilution regimen consisting of 500 ml of 10% hydroxyethyl starch per day for 10 days. In the high haematocrit group the target haematocrit of 41-42% was achieved by 0-3 phlebotomies and additional replacement of that volume with the colloid in 3 days. In the low haematocrit group with 1-4 phlebotomies a target haematocrit of 37-38% was reached in 4 days. The groups did not differ regarding age, risk factors, haematocrit and neurological score. The improvement of the disturbed blood rheology was more pronounced in the low haematocrit group. One death occurred in each group. The neurological score showed a significantly greater increase in the low haematocrit group with +59% at day 5 and +125% at day 11; the data for the high haematocrit group were +34% and +89% respectively. We calculated a correlation (r = 0.36, p less than 0.02) between the rise in neurological score and the reduction of haematocrit. Our data suggest but not do prove that an early start on moderate hypervolemic haemodilution is beneficial in patients with acute ischaemic stroke and disturbed blood rheology.
在一项前瞻性研究中，我们将50例在发病后12小时内出现大脑中动脉区域急性缺血性卒中的患者随机分为两种中度高血容量血液稀释方案组，每组每天给予500毫升10%的羟乙基淀粉，共10天。在高血细胞比容组，通过0至3次放血，在3天内使血细胞比容达到41% - 42%的目标值，并补充等量的胶体液。在低血细胞比容组，通过1至4次放血，在4天内使血细胞比容达到37% - 38%的目标值。两组在年龄、危险因素、血细胞比容和神经功能评分方面无差异。低血细胞比容组血液流变学紊乱的改善更为明显。每组各有1例死亡。神经功能评分显示，低血细胞比容组在第5天显著增加59%，在第11天增加125%；高血细胞比容组的数据分别为34%和89%。我们计算出神经功能评分的升高与血细胞比容的降低之间存在相关性（r = 0.36，p < 0.02）。我们的数据表明但未证实，早期开始中度高血容量血液稀释对急性缺血性卒中和血液流变学紊乱的患者有益。
