Lyden P D, Alving L I, Zivin J A, Rothrock J F
Department of Neurology, Veterans Administration Medical Center, San Diego, CA 92161.
Stroke. 1988 Feb;19(2):223-7. doi: 10.1161/01.str.19.2.223.
Newly developed colloid volume-expanding agents with mean molecular weights lower than currently available agents may improve outcome after stroke with fewer allergic and coagulation system side effects. The smaller molecule, however, may exacerbate ischemic cerebral edema if it accumulates in areas where ischemia has damaged the blood-brain barrier. We administered low-molecular-weight hydroxyethyl starch to rabbits after embolic infarction and measured specific gravity and total water content. We found evidence of ischemic edema in the hemisphere ipsilateral to the embolic arterial occlusion, but the measures of edema were not different in treated and control groups. Of those rabbits suffering severe neurologic deficit, mortality was 2 of 13 in the treated compared with 7 of 12 in the control groups (p less than 0.01). Thus, hemodilution with low-molecular-weight hydroxyethyl starch did not exacerbate cerebral edema and may have improved survival in this model.
新研发的平均分子量低于现有药物的胶体容量扩充剂，可能会改善中风后的预后，且过敏和凝血系统副作用更少。然而，如果小分子积聚在缺血已破坏血脑屏障的区域，可能会加重缺血性脑水肿。我们在兔栓塞性梗死之后给予低分子量羟乙基淀粉，并测量其比重和总含水量。我们发现栓塞动脉闭塞同侧半球存在缺血性水肿的证据，但治疗组和对照组的水肿指标并无差异。在那些出现严重神经功能缺损的兔子中，治疗组13只中有2只死亡，而对照组12只中有7只死亡（p小于0.01）。因此，在该模型中，用低分子量羟乙基淀粉进行血液稀释并未加重脑水肿，且可能提高了存活率。
