Gröger U, Marmarou A
Department of Neurosurgery, University of Bern, Switzerland.
Adv Neurol. 1990;52:215-8.
This study shows that there is a quantitative relation between the protein content of edema fluid and the rate of fluid clearance. Minimal clearance takes place during the first 3 days in the high albumin group. Thereafter, the majority of the fluid is cleared, and tissue water returns to normal values by 8 days. This appears to support an idea that the rate of clearance is in direct proportion to protein concentration. This also supports the findings of Kuroiwa et al. who showed a direct relation between protein extravasation and the increase of water in extracellular vasogenic edema. However, the rate of clearance does not in fact appear to be linear with time as the greater percentage of protein edema fluid is cleared after 3 days. This may be explained by the observations of Rasmussen and Klatzo and Bodsch and Hossmann who indicate that the composition of the extracellular protein may undergo various changes, similar to fragmentation, hence increasing the number of osmotically active particles so the pre-existing edema would remain stable or slightly increase. In conclusion, this study demonstrates that the infusion model of edema can be applied to the rat for study of resolution dynamics. We have also shown that in this model, there is a proportional relation between protein concentration of the edema fluid and time necessary for clearance.
本研究表明,水肿液的蛋白质含量与液体清除率之间存在定量关系。在高白蛋白组中,最初3天清除率最低。此后,大部分液体被清除,到第8天时组织水分恢复至正常水平。这似乎支持了清除率与蛋白质浓度成正比的观点。这也支持了黑岩等人的研究结果,他们发现蛋白质外渗与细胞外血管源性水肿中水分增加之间存在直接关系。然而,实际上清除率与时间并非呈线性关系,因为3天后蛋白质性水肿液的清除比例更大。这可能可以用拉斯穆森、克拉佐以及博德施和霍斯曼的观察结果来解释,他们指出细胞外蛋白质的组成可能会发生各种变化,类似于碎片化,从而增加了具有渗透活性的颗粒数量,因此先前存在的水肿将保持稳定或略有增加。总之,本研究表明水肿输注模型可应用于大鼠以研究消退动力学。我们还表明,在该模型中,水肿液的蛋白质浓度与清除所需时间之间存在比例关系。