Oian P, Maltau J M, Noddeland H, Fadnes H O
Br J Obstet Gynaecol. 1986 Mar;93(3):235-9. doi: 10.1111/j.1471-0528.1986.tb07899.x.
The fluid transport between the plasma and interstitial fluid compartment is governed by the Starling forces, i.e. the capillary pressure (Pc), interstitial fluid hydrostatic pressure (Pi) and colloid osmotic pressure in plasma (COPp) and interstitial fluid (COPi). Interstitial fluid was collected from subcutaneous tissue on the thorax and ankle by implanted wicks and Pi was measured using the 'wick-in-needle' technique. In pre-eclampsia, COPp is reduced due to hypoproteinaemia and this predisposes towards loss of fluid from the vascular compartment. An important oedema-preventing mechanism is reduction of COPi, which serves as a homeostatic buffer against increased capillary filtration. This mechanism works in moderate, but not in severe pre-eclampsia. A higher COPi was found both at the thorax (8.3 vs 7.0 mmHg) and ankle (5.9 vs 3.9 mmHg) in the group with severe pre-eclampsia compared with the group moderate pre-eclampsia, in spite of a significant reduction in COPp (15.5 vs 19.9 mmHg). These findings suggest that an increased microvascular permeability of plasma proteins to subcutaneous tissue contributes to COPp reduction in severe pre-eclampsia.
血浆与组织间液之间的液体转运受Starling力的控制，即毛细血管压力（Pc）、组织间液静水压（Pi）以及血浆（COPp）和组织间液（COPi）中的胶体渗透压。通过植入灯芯从胸部和脚踝的皮下组织收集组织间液，并使用“针内灯芯”技术测量Pi。在子痫前期，由于低蛋白血症，COPp降低，这使得血管内液体流失。一个重要的预防水肿机制是COPi降低，它作为一种稳态缓冲机制来对抗毛细血管滤过增加。这种机制在中度子痫前期起作用，但在重度子痫前期不起作用。与中度子痫前期组相比，重度子痫前期组在胸部（8.3对7.0 mmHg）和脚踝（5.9对3.9 mmHg）均发现较高的COPi，尽管COPp显著降低（15.5对19.9 mmHg）。这些发现表明，血浆蛋白对皮下组织的微血管通透性增加导致重度子痫前期COPp降低。
