Department of Anesthesiology, University of Arizona College of Medicine, Tucson, AZ, USA.
Department of Pathology, University of Arizona College of Medicine, Tucson, AZ, USA.
Crit Care. 2022 Sep 12;26(1):273. doi: 10.1186/s13054-022-04154-2.
Preclinical studies in animals and human clinical trials question whether the endothelial glycocalyx layer is a clinically important permeability barrier. Glycocalyx breakdown products in plasma mostly originate from 99.6-99.8% of the endothelial surface not involved in transendothelial passage of water and proteins. Fragment concentrations correlate poorly with in vivo imaging of glycocalyx thickness, and calculations of expected glycocalyx resistance are incompatible with measured hydraulic conductivity values. Increases in plasma breakdown products in rats did not correlate with vascular permeability. Clinically, three studies in humans show inverse correlations between glycocalyx degradation products and the capillary leakage of albumin and fluid.
动物临床前研究和人体临床试验质疑内皮糖萼层是否是一种具有临床重要性的通透性屏障。血浆中的糖萼层破坏产物主要来源于 99.6%-99.8%的内皮表面，这些内皮表面不参与水和蛋白质的跨内皮转运。片段浓度与糖萼层厚度的体内成像相关性较差，而预期糖萼层阻力的计算与测量的水力传导率值不兼容。大鼠血浆中破坏产物的增加与血管通透性无关。临床上，三项人体研究表明糖萼降解产物与白蛋白和液体的毛细血管渗漏之间呈负相关。
