Adt M, Reimann H J, Weinhold C, Weigand R, Schmucker P, Kemkes B M
Institut für Anaesthesiologie, Deutsches Herzzentrum Berlin.
Anaesthesist. 1988 Aug;37(8):498-503.
This study demonstrates a very rapid and short-lasting elevation of plasma histamine concentrations after heparin injection prior to cannulation for extracorporeal circulation during cardiac surgery. Plasma histamine concentrations increased significantly for less than 1 min following bolus injection of heparin into the right atrium. Blood samples were taken from the distal pulmonary vascular bed, i.e. the pulmonary vein. The design of the study enabled us to observe the development of plasma histamine concentrations within very short time intervals and to detect the high peak plasma histamine concentration that may occur, primarily in the pulmonary outstream vessels. Therefore, the histamine found here could originate from intrathoracically located mast cells. It is more likely, however, that the histamine was administered together with the heparin in complex binding, due to purification problems. The amount of histamine found in this study was sufficient to produce mild to severe circulatory effects in all patients receiving a high dose of heparin.
本研究表明，在心脏手术体外循环插管前注射肝素后，血浆组胺浓度会迅速且短暂地升高。在将肝素推注到右心房后不到1分钟内，血浆组胺浓度显著升高。血样取自远端肺血管床，即肺静脉。该研究的设计使我们能够在非常短的时间间隔内观察血浆组胺浓度的变化，并检测到可能出现的血浆组胺浓度高峰，主要出现在肺流出血管中。因此，此处发现的组胺可能源自胸腔内的肥大细胞。然而，更有可能的是，由于纯化问题，组胺与肝素以复合物结合的形式一同给药。本研究中发现的组胺量足以在所有接受高剂量肝素的患者中产生轻度至重度的循环影响。
