Hartmann A, Tsuda Y, Lagrèze H
Neurologische Universitätsklinik, Bonn, Federal Republic of Germany.
J Neurol. 1987 Oct;235(1):34-8. doi: 10.1007/BF00314195.
A controlled study of the effect of hypervolaemic haemodilution on cerebral blood flow (CBF) was performed using 10% hydroxyethylstarch (HES) in 27 patients with acute cerebral ischaemia. Of the patients, 12 were randomly allocated as controls without HES infusion and 15 received 500 ml HES daily, infused over a period of 5-7 h, for 7 days. CBF was measured on days 1, 2 and 7 by the xenon 133 inhalation method and calculated as initial slope index. In the HES-treated group, CBF increased in both hemispheres (P less than 0.001) from day 1 to day 2 and, in addition, in the infarcted hemispheres from day 2 to day 7 (P less than 0.01). In the control group, the hemispheric flow of the involved side had decreased (P less than 0.001) by day 2 and had not significantly changed by day 7; however, in the contralateral hemisphere flow did not change. In hypaemic regions the increase in flow was larger than in other regions in both groups. Regional flow had increased more in the HES-treated group than in controls at both day 2 (P less than 0.01) and day 7 (P less than 0.002). Hypervolaemic haemodilution with HES was able to improve hemispheric and regional flow significantly, particularly in infarcted hemispheres and hypaemic regions with acute cerebral ischaemia.
采用10%羟乙基淀粉（HES）对27例急性脑缺血患者进行了高容量血液稀释对脑血流量（CBF）影响的对照研究。其中12例患者被随机分配为未输注HES的对照组，15例患者每天接受500 ml HES，在5 - 7小时内输注，共7天。在第1天、第2天和第7天，采用氙133吸入法测量CBF，并计算为初始斜率指数。在HES治疗组中，从第1天到第2天，两个半球的CBF均增加（P < 0.001），此外，从第2天到第7天，梗死半球的CBF也增加（P < 0.01）。在对照组中，患侧半球血流量在第2天减少（P < 0.001），到第7天无明显变化；然而，对侧半球血流量没有改变。在低灌注区域，两组血流量的增加均大于其他区域。在第2天（P < 0.01）和第7天（P < 0.002），HES治疗组的区域血流量增加均多于对照组。HES进行高容量血液稀释能够显著改善半球和区域血流量，尤其是在急性脑缺血的梗死半球和低灌注区域。
