Kienlen J, Mathieu-Daudé J C, Passeron D, Dellord A, d'Athis F, du Cailar J
Département d'Anesthésie-Réanimation A, Hôpital Lapeyronie, Montpellier.
Ann Fr Anesth Reanim. 1990;9(6):495-500. doi: 10.1016/s0750-7658(05)80221-7.
A study was carried out to assess the changes induced by an infusion of dextran, molecular weight 60,000 daltons, in blood and urine. Plasma and urine dextran and serum protein concentrations, haematocrit, blood and urine viscosities, and blood oncotic pressure were measured in 10 consecutive male patients. Fifteen min after administration of 20 ml dextran 1000 (Promit), they were each given 500 ml (30 g) dextran 60 (Hemodex) over 30 min for plasma volume expansion. The measurements were carried out at the end of the infusion, and then at regular intervals over a 48 h period. The highest dextran blood concentrations were found at the end of the infusion, decreasing thereafter with a distribution half-life of 1.83 +/- 0.64 h, and an elimination half-life of 25.5 +/- 7.6 h. Haematocrit values decreased by 12%, and serum protein concentrations by 9.5%, after the end of the infusion. These changes remained significant for 9 h; they were probably due to the dilution effect of 500 ml of dextran. Colloid osmotic pressure was not significantly altered (20.7 +/- 4.7 mmHg vs. 23.1 +/- 5.1 mmHg 48 h after the end of the infusion). The colloid osmotic pressure due to dextran 60 compensated for the fall in protein concentration. A decrease in blood viscosity was found at different shear rates, despite dextran 60 being highly viscous. This could also be explained by a dilution effect. The highest degree of urinary excretion occurred 30 min after the end of the infusion, and lasted for 3 h. Forty-five percent of the total dextran dose had been excreted by the 48th hour.(ABSTRACT TRUNCATED AT 250 WORDS)
开展了一项研究，以评估输注分子量为60,000道尔顿的右旋糖酐对血液和尿液的影响。对10名连续的男性患者测量了血浆和尿液中的右旋糖酐、血清蛋白浓度、血细胞比容、血液和尿液粘度以及血液胶体渗透压。在给予20ml右旋糖酐1000（Promit）15分钟后，在30分钟内给每位患者输注500ml（30g）右旋糖酐60（Hemodex）以扩充血浆容量。在输注结束时进行测量，然后在48小时内定期测量。输注结束时发现右旋糖酐的血药浓度最高，此后下降，分布半衰期为1.83±0.64小时，消除半衰期为25.5±7.6小时。输注结束后，血细胞比容值下降了12%，血清蛋白浓度下降了9.5%。这些变化在9小时内仍很显著；可能是由于500ml右旋糖酐的稀释作用。胶体渗透压没有显著改变（输注结束后48小时为20.7±4.7mmHg，而之前为23.1±5.1mmHg）。右旋糖酐60引起的胶体渗透压补偿了蛋白质浓度的下降。尽管右旋糖酐60粘度很高，但在不同剪切速率下仍发现血液粘度降低。这也可以用稀释作用来解释。输注结束后30分钟出现最高程度的尿排泄，并持续3小时。到第48小时，已排泄了总右旋糖酐剂量的45%。（摘要截断于250字）
