Knox P, Levick J R, McDonald J N
Department of Biochemistry, St George's Hospital Medical School, London.
Q J Exp Physiol. 1988 Jan;73(1):33-45. doi: 10.1113/expphysiol.1988.sp003121.
Synovial fluid from rabbit elbow, shoulder, hip and knee was analysed to establish the normal levels of parameters relevant to fluid exchange viz. fluid mass per joint, hydraulic pressure, temperature, colloid osmotic pressure (COP), protein, albumin and glycosaminoglycan (GAG) concentrations. Fluid mass was greatest in the least congruous joint, the shoulder (43 +/- 4 mg), cf. 6 +/- 2 mg in the highly congruous hip. In the knee (24 +/- 4 mg) the mean thickness of the fluid layer was calculated to be 30 microns. Fluid pressure was subatmospheric in all joints (mean -2.8 +/- 0.4 cmH2O, elbow, to -5.7 +/- 0.3 cmH2O, knee), as in many other interstitial spaces. Colloid osmotic pressure was substantial (mean 11.4 +/- 0.9 cmH2O, shoulder, to 13.1 +/- 1.0 cmH2O, elbow), being 40-46% of serum level. Comparison of synovial fluid results with COP versus concentration curves in vitro indicated that the fluid's COP was primarily generated by its protein content (22-30 g l-1, 64% albumin) rather than GAG (4.0-5.8 g l-1). The GAG was 95% hyaluronate and 5% sulphated GAG. Algebraic summation of the hydraulic and colloid osmotic pressures of synovial fluid and serum indicated a net filtration gradient from blood to joint cavity. When serum COP was reduced by intravenous saline infusion, synovial fluid mass increased, in accordance with the ultrafiltration hypothesis of synovial fluid formation. The fluid's colloid concentration declined as volume increased. The relation was not a simple dilution curve, but indicated that the newly formed synovial fluid contained greater than or equal to 8 g protein l-1 (14.5% serum concentration); and that hyaluronate was entering the synovial cavity at a rate of greater than or equal to 6.5 micrograms h-1 per joint.
对来自兔肘、肩、髋和膝关节的滑液进行分析,以确定与液体交换相关参数的正常水平,即每个关节的液体量、液压、温度、胶体渗透压(COP)、蛋白质、白蛋白和糖胺聚糖(GAG)浓度。液体量在一致性最差的关节即肩部最大(43±4毫克),相比之下,高度一致的髋关节为6±2毫克。在膝关节(24±4毫克)中,液体层的平均厚度经计算为30微米。与许多其他组织间隙一样,所有关节的液压均低于大气压(肘关节平均为-2.8±0.4厘米水柱,膝关节为-5.7±0.3厘米水柱)。胶体渗透压相当可观(肩部平均为11.4±0.9厘米水柱,肘关节为13.1±1.0厘米水柱),为血清水平的40%-46%。体外将滑液结果与COP对浓度曲线进行比较表明,滑液的COP主要由其蛋白质含量(22-30克/升,64%为白蛋白)而非GAG(4.0-5.8克/升)产生。GAG中95%为透明质酸盐,5%为硫酸化GAG。滑液和血清的液压与胶体渗透压的代数和表明存在从血液到关节腔的净滤过梯度。当通过静脉输注生理盐水降低血清COP时,滑液量增加,这与滑液形成的超滤假说相符。随着体积增加,液体的胶体浓度下降。这种关系并非简单的稀释曲线,而是表明新形成的滑液含有大于或等于8克/升蛋白质(血清浓度的14.5%);并且透明质酸盐以每个关节大于或等于6.5微克/小时的速率进入滑膜腔。