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[在定期透析患者中右旋糖酐的医源性全身蓄积]

[Iatrogenic generalized storage of dextran in regularly dialyzed patients].

作者信息

Stejskalová A, Stejskal J, Elleder M

出版信息

Cesk Patol. 1986 Mar;22(1):1-9.

PMID:2420481
Abstract

Intensive generalized intracellular storage of a PAS positive birefringent material with unusual ultrastructure was found in 17 patients deceased after long-term hemodialysis. It was identified as "condensed" dextran administered repeatedly for hypotension during dialysis. Intensity of storage was related to residual diuresis and not to the number of dialyses. Identification of the material was enabled by digestion with dextranase. Dextran cytoplasmic inclusions in macrophages resisted to common solvents but dissolved in lyes. The storage occurred in lymph-nodes, in the heart, kidney interstitium, bone marrow and others. Fatal complications of massive dextran storage were discussed. Quantity, morphogenesis and location of storage are learning about storing systems.

摘要

在17例长期血液透析后死亡的患者中,发现一种具有异常超微结构的PAS阳性双折射物质在细胞内广泛密集储存。它被鉴定为在透析过程中因低血压而反复给予的“浓缩”葡聚糖。储存强度与残余尿量有关,而与透析次数无关。通过用葡聚糖酶消化能够鉴定该物质。巨噬细胞中的葡聚糖胞质内含物能抵抗常见溶剂,但可溶于碱液。储存发生在淋巴结、心脏、肾间质、骨髓等部位。讨论了大量葡聚糖储存的致命并发症。储存的数量、形态发生和位置有助于了解储存系统。

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