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肝素或纤维蛋白原耗竭对绵羊栓塞后肺液体平衡的影响。

Effect of heparin or fibrinogen depletion on lung fluid balance in sheep after emboli.

作者信息

Binder A S, Nakahara K, Ohkuda K, Kageler W, Staub N C

出版信息

J Appl Physiol Respir Environ Exerc Physiol. 1979 Jul;47(1):213-9. doi: 10.1152/jappl.1979.47.1.213.

Abstract

Investigators have proposed that fibrinogen, fibrin, or their degradation products are essential for the increased lung vascular permeability to fluid and protein that may occur after microemboli. To test this hypothesis, we used 20 anesthetized ventilated sheep in which we measured lung lymph flow, pulmonary artery and left atrial pressures, thermodilution cardiac output, and lymph/plasma protein concentrations. We injected glass bead microemboli (200 micrometers diam) sufficient to raise pulmonary vascular resistance to three times base-line values and cause increased lung lymph flow with a parallel increase in protein clearance, which is characteristic of increased lung vascular permeability. Neither large doses of heparin (3,000 U/kg) nor fibrinogen depletion with viper venom (ancrod, 2 U/kg), by themselves, affected steady-state pulmonary hemodynamics or lung fluid balance. These treatments prior to giving sufficient amounts of emboli to triple the pulmonary vascular resistance did not prevent the increased lung vascular permeability. We conclude that neither fibrin deposition nor degradation are essential to microembolic lung vascular injury in sheep.

摘要

研究人员提出,纤维蛋白原、纤维蛋白或其降解产物对于微栓子后可能出现的肺血管对液体和蛋白质通透性增加至关重要。为了验证这一假设,我们使用了20只麻醉通气的绵羊,测量了肺淋巴流量、肺动脉和左心房压力、热稀释心输出量以及淋巴/血浆蛋白浓度。我们注射了玻璃珠微栓子(直径200微米),足以使肺血管阻力增加到基线值的三倍,并导致肺淋巴流量增加,同时蛋白质清除率平行增加,这是肺血管通透性增加的特征。单独使用大剂量肝素(3000 U/kg)或用蝰蛇毒(安克洛酶,2 U/kg)消耗纤维蛋白原,均未影响稳态肺血流动力学或肺液体平衡。在给予足够量的栓子使肺血管阻力增加两倍之前进行这些治疗,并不能预防肺血管通透性增加。我们得出结论,纤维蛋白沉积和降解对于绵羊微栓子性肺血管损伤均非必需。

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