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糖皮质激素治疗血管源性水肿。

Glucocorticosteroid treatment of vasogenic oedema.

作者信息

Rommel T, Bodsch W

机构信息

Neurochirurgische Klinik des Städtischen Krankenhauses Köln-Merheim, Federal Republic of Germany.

出版信息

Acta Neurochir Suppl (Wien). 1988;43:145-8. doi: 10.1007/978-3-7091-8978-8_31.

Abstract

The components of vasogenic oedema associated with brain tumours were investigated in human biopsy material sampled from tumour and peritumoural tissue intraoperatively. Sixty patients with glioblastomas, gliomas, meningiomas and metastases, which had been treated with dexamethasone prior to surgery were employed for tissue measurements of water, electrolyte, haemoglobin, serum protein and dexamethasone concentrations. The quantification of serum proteins was achieved with the method described by Bodsch et al. Accordingly, serum proteins in the brain tissue and the blood were determined with 125J labelled antihuman antibody. Taking into account brain haematocrit and blood-volume, quantitative measurements of the so-called oedema proteins as a measure of tumour oedema were performed. With the exception of metastases positive correlations were obtained between water and both serum proteins and sodium contents in tumours and peritumoural tissue. The serum protein content varied considerably being high in glioblastomas and low in peritumoural tissue surrounding metastases. However water and serum protein contents decreased with increasing dexamethasone concentrations in glioblastomas, while this effect was virtually absent in gliomas and meningiomas. Our results suggest a previously unknown selectivity among tumour types for the reduction of water content and serum proteins in corticosteroid treated oedematous tissue.

摘要

在术中从肿瘤及瘤周组织采集的人体活检材料中,对与脑肿瘤相关的血管源性水肿的成分进行了研究。60例胶质母细胞瘤、胶质瘤、脑膜瘤和转移瘤患者在术前接受了地塞米松治疗,用于对水、电解质、血红蛋白、血清蛋白和地塞米松浓度进行组织测量。血清蛋白的定量采用博德施等人描述的方法。据此,用125I标记的抗人抗体测定脑组织和血液中的血清蛋白。考虑到脑血细胞比容和血容量,对所谓的水肿蛋白进行定量测量,作为肿瘤水肿的指标。除转移瘤外,肿瘤及瘤周组织中的水与血清蛋白和钠含量之间均呈正相关。血清蛋白含量差异很大,胶质母细胞瘤中含量高,转移瘤周围的瘤周组织中含量低。然而,在胶质母细胞瘤中,水和血清蛋白含量随地塞米松浓度升高而降低,而在胶质瘤和脑膜瘤中几乎没有这种效应。我们的结果表明,在接受皮质类固醇治疗的水肿组织中,肿瘤类型之间对水含量和血清蛋白降低存在此前未知的选择性。

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