Laxenaire M C, Aug F, Voisin C, Chevreaud C, Bauer P, Bertrand A
Ann Fr Anesth Reanim. 1986;5(3):218-22. doi: 10.1016/s0750-7658(86)80146-0.
Ten patients (9 males and 1 female: mean age: 64.8 +/- 7 yr) were studied. They were all stabilized coronary heart disease patients free of cardiac failure who where to undergo normovolaemic haemodilution as medical treatment of lower limb arteritis. Ventricular function was assessed by a radioisotope method: myocardial perfusion (thallium-201 and dipyridamole scintillation scan) and left ventricular contraction by technetium-99m angiography. Blood volume was measured by iodine-131 marked albumin. The following parameters were also measured: plasma viscosity, blood viscosity at seven different speeds, red blood cell aggregation index and filtration index. These were all measured before and 24 h after normovolaemic haemodilution which was carried out with à 5% albumin solution. This haemodilution was well tolerated: 1,062 +/- 335 ml of blood were sampled, the same volume of albumin being transfused, thus reducing the mean haematocrit from 0.42 +/- 0.05 to 0.32 +/- 0.02 (p less than 0.01). Normovolaemia was respected. Blood viscosity was reduced, especially at low speeds and the red blood cell aggregation index was also reduced. Ventricular contraction did not vary. Moreover, the basal myocardial state as assessed by the thallium scintillation count was not modified by the haemodilution, even being improved in three cases. The dipyridamole perfusion (the equivalent of an effort test) gave no changes in seven patients, resolved the ischaemic signs in two patients and slightly increased ischaemia in one case.
对10例患者(9例男性,1例女性;平均年龄:64.8±7岁)进行了研究。他们均为稳定型冠心病患者,无心力衰竭,因下肢动脉炎接受等容血液稀释治疗。采用放射性核素方法评估心室功能:心肌灌注(铊 - 201和双嘧达莫闪烁扫描)以及通过锝 - 99m血管造影评估左心室收缩功能。通过碘 - 131标记的白蛋白测量血容量。还测量了以下参数:血浆粘度、七种不同速度下的血液粘度、红细胞聚集指数和滤过指数。这些参数均在使用5%白蛋白溶液进行等容血液稀释前及稀释后24小时测量。这种血液稀释耐受性良好:采集了1062±335毫升血液,输注了相同体积的白蛋白,从而使平均血细胞比容从0.42±0.05降至0.32±0.02(p<0.01)。维持了血容量正常。血液粘度降低,尤其是在低速时,红细胞聚集指数也降低。心室收缩功能未发生变化。此外,通过铊闪烁计数评估的基础心肌状态未因血液稀释而改变,甚至有3例得到改善。双嘧达莫灌注(相当于负荷试验)在7例患者中无变化,2例患者的缺血体征得到缓解,1例患者的缺血稍有增加。