Chevreaud C, Thouvenot P, Burdin D, Laxenaire M C, Fiévé G
Ann Fr Anesth Reanim. 1986;5(3):223-8. doi: 10.1016/s0750-7658(86)80147-2.
Thirty patients suffering from arterial occlusive disease (stages II, III or IV of Fontaine's classification) were treated by isovolaemic haemodilution (IDH). Most of these patients received conventional medical treatment without success (negative selection). Angiography was performed on all patients prior to treatment. 500 ml of whole blood was withdrawn from each patient. 250 ml of dextran 40 mixed with 250 ml of 5% albumin solution was injected intravenously to avoid hypovolaemia. This procedure, carried out three or four times, was repeated until a haematocrit of 0.30 was reached. This haematocrit level of 0.30-0.35 was maintained for 60 days. The measurement of ankle systolic pressure, systolic index at rest, treadmill performance and lower limb thallium-201 muscular scintigraphy were used to assess laboratory efficiency. On the sixtieth day, 14 patients (46%) showed clinical improvement, nine were stable and arterial occlusive disease worsened in seven patients. Clinical improvement persisted for several months (15 months in one case). Clinically, it seemed that patients treated by IHD showed improvement of their arterial occlusive disease. However, the prediction of the chances of success of IHD, as well as the quantification of results by common laboratory examination, were difficult. Muscular scintigraphy with thallium-201 gave a good assessment as well as a quantifiable analysis of results.
30例患有动脉闭塞性疾病（Fontaine分级II、III或IV期）的患者接受了等容血液稀释（IDH）治疗。这些患者中的大多数接受传统药物治疗但未成功（阴性选择）。所有患者在治疗前均进行了血管造影。从每位患者身上抽取500毫升全血。静脉注射250毫升右旋糖酐40与250毫升5%白蛋白溶液的混合液以避免血容量过低。此过程进行三到四次，重复进行直至血细胞比容达到0.30。将0.30 - 0.35的血细胞比容水平维持60天。通过测量踝部收缩压、静息收缩指数、跑步机运动表现和下肢铊-201肌肉闪烁显像来评估治疗效果。在第60天时，14例患者（46%）显示临床症状改善，9例病情稳定，7例患者的动脉闭塞性疾病恶化。临床改善持续了数月（1例持续15个月）。临床上，接受等容血液稀释治疗的患者似乎其动脉闭塞性疾病有所改善。然而，对等容血液稀释成功几率的预测以及通过常规实验室检查对结果进行量化都很困难。铊-201肌肉闪烁显像能很好地评估并对结果进行可量化分析。
