人体化疗期间毛细血管渗漏的证据。

Evidence for capillary leakage during chemotherapy in man.

作者信息

de Vries E G, Beekhuis H, de Jong R, Mulder N H, Piers D A

出版信息

Eur J Clin Invest. 1986 Jun;16(3):243-7. doi: 10.1111/j.1365-2362.1986.tb01336.x.

DOI:10.1111/j.1365-2362.1986.tb01336.x

Abstract

The influence of intensive chemotherapy with high dose VP 16-213, cyclophosphamide and autologous bone marrow transplantation on transcapillary escape rate of albumin was evaluated. Transcapillary escape rate and plasma volume were measured with 131I-labelled albumin. Measurements were performed 1 day before (T0), 1 week after (T1) and 2 weeks after (T2) start of chemotherapy. Before therapy TER (n = 7, means = 7.1% h-1) was already raised in patients compared to controls (n = 5, means = 3.8% h-1, P less than 0.025). No difference was found for transcapillary escape rate on T1 (n = 9, means = 7.6% h-1) compared to T0. There was an increase of transcapillary escape rate from T0 to T2 (n = 8, means = 9.5% h-1, P less than 0.05). Plasma volume did not change during therapy. Serum albumin concentrations were reduced before chemotherapy (means = 38 g 1(-1] compared to controls (means = 44 g l(-1]. After 1 (means = 34 g 1(-1] and 2 weeks (means = 31 g 1(-1] these concentrations decreased further. The same was found for intravascular mass of albumin related to body weight. The intravascular mass of albumin/bodyweight and the transcapillary escape rate are related in the patients (r = -0.477, P less than 0.01) and the patients plus controls (r = -0.585, P less than 0.001). This means the higher the transcapillary escape rate the lower the intravascular mass of albumin. No correlation between transcapillary escape rate and presence of fever was found. It can be concluded that intensive chemotherapy leads to further increase of an already elevated transcapillary escape rate for albumin.

摘要

评估了大剂量VP 16 - 213、环磷酰胺强化化疗及自体骨髓移植对白蛋白毛细血管逸出率的影响。采用131I标记的白蛋白测量毛细血管逸出率和血浆容量。在化疗开始前1天（T0）、化疗开始后1周（T1）和化疗开始后2周（T2）进行测量。与对照组（n = 5，平均值 = 3.8% h-1，P < 0.025）相比，患者在治疗前TER（n = 7，平均值 = 7.1% h-1）就已经升高。与T0相比，T1时（n = 9，平均值 = 7.6% h-1）毛细血管逸出率未发现差异。从T0到T2毛细血管逸出率有所增加（n = 8，平均值 = 9.5% h-1，P < 0.05）。治疗期间血浆容量未发生变化。化疗前血清白蛋白浓度降低（平均值 = 38 g l-1），而对照组为（平均值 = 44 g l-1）。1周后（平均值 = 34 g l-1）和2周后（平均值 = 31 g l-1）这些浓度进一步下降。与体重相关的白蛋白血管内质量也有同样的情况。患者组（r = -0.477，P < 0.01）以及患者加对照组（r = -0.585，P < 0.001）中，白蛋白血管内质量/体重与毛细血管逸出率相关。这意味着毛细血管逸出率越高，白蛋白血管内质量越低。未发现毛细血管逸出率与发热之间存在相关性。可以得出结论，强化化疗导致白蛋白毛细血管逸出率在已升高的基础上进一步增加。