Zikria B A, King T C, Stanford J, Freeman H P
College of Physicians and Surgeons, Columbia University, New York N.Y.
Surgery. 1989 May;105(5):625-31.
In this preliminary report, the capillary leakage that occurs after scald injury is considered a biophysical phenomenon and is treated by sealing the "pores," or endothelial gaps, in the capillary membranes with biodegradable macromolecules of the appropriate size and shape. We have measured albumin leakage from standardized scald burns in the rat jejunum with and without variously sized fractions of intravenous macromolecules of hydroxyethyl starch (HES) used as a sealing agent. The observed reduction of albumin leakage from injured capillaries was attributed to the sealing effect. The fraction HES (Fm) with molecular weights of 100,000 to 300,000 daltons performed significantly better (p less than 0.05) as a sealing agent when compared with HES (F1) fraction molecular weights of 300,000 to 3.4 million daltons, HES (Fs) molecular weight less than 50,000 daltons, and two control groups receiving the intravenous Ringer's lactate solution or serum albumin 5%. This capillary sealing phenomenon was shown to be independent of colloid osmotic pressure effect. It is believed to be related to the size and the shape of the noncharged macromolecules.
在本初步报告中，烫伤后发生的毛细血管渗漏被视为一种生物物理现象，可通过用大小和形状合适的可生物降解大分子封闭毛细血管膜中的“孔隙”（即内皮间隙）来进行治疗。我们已测量了在有或没有使用不同大小级分的羟乙基淀粉（HES）静脉大分子作为封闭剂的情况下，大鼠空肠标准化烫伤后的白蛋白渗漏情况。观察到的受伤毛细血管白蛋白渗漏减少归因于封闭作用。与分子量为300,000至340万道尔顿的HES（F1）级分、分子量小于50,000道尔顿的HES（Fs）以及接受静脉注射乳酸林格氏液或5%血清白蛋白的两个对照组相比，分子量为100,000至300,000道尔顿的HES（Fm）级分作为封闭剂的效果明显更好（p小于0.05）。这种毛细血管封闭现象被证明与胶体渗透压效应无关。据信它与不带电荷的大分子的大小和形状有关。
