Köhler H, Zschiedrich H, Linfante A, Appel F, Pitz H, Clasen R
Klin Wochenschr. 1982 Mar;60(6):293-301. doi: 10.1007/BF01716806.
After withdrawal of 400 ml whole blood and subsequent infusion of 500 ml of a colloidal plasma substituent, the intravascular and renal colloid elimination was investigated in 40 test subjects. The individual colloidal solutions could no longer be demonstrated in the intravascular space after the following times: 10% hydroxyethyl starch 200/0.5 (anthrone method) after six weeks, 10% dextran 40 (anthrone method) after two weeks, 6% hydroxyethyl starch 200/0.5 (anthrone method) after four weeks and 5.5% oxypolygelatine (hydroxyproline method) after two days. Colloidal plasma substitutes are polydisperse solutions with various molecular weights and degree of hydroxyethylation and therefore, also have a large number of different elimination constants. With repeated application, the intravascular colloid concentration shifts in favour of the molecules with a longer half life which are difficult to eliminate. The elimination of the clinically employed dextran 40 and oxypolygelatine solution could be best described with an open two-compartment model. As a result of its greater heterogeneity, the elimination of the moderately high molecular weight hydroxyethyl starch 200/0.5 could only be characterized approximately even assuming three elimination constants. In the first four days, the hydroxyethyl starch 200/0.5 was more rapidly eliminated compared to dextran 40. However, subsequently a very much lower elimination from the intravascular space was found for about 3% of the administered hydroxyethyl starch 200/0.5. Oxypolygelatine was eliminated especially rapidly. Accordingly, the greatest renal clearance was found for oxypolygelatine, which showed a close relation to the molecular weight. On the other hand, a rapid elimination simultaneously is followed by a correspondingly lower volume effect.
抽取400毫升全血并随后输注500毫升胶体血浆代用品后，对40名受试对象的血管内和肾脏胶体清除情况进行了研究。在以下时间后，血管内空间中已无法再检测到各个胶体溶液：6周后10%羟乙基淀粉200/0.5（蒽酮法）、2周后10%右旋糖酐40（蒽酮法）、4周后6%羟乙基淀粉200/0.5（蒽酮法）以及2天后5.5%氧化聚明胶（羟脯氨酸法）。胶体血浆代用品是具有不同分子量和羟乙基化程度的多分散溶液，因此也有大量不同的清除常数。重复应用时，血管内胶体浓度会向半衰期较长、难以清除的分子方向偏移。临床使用的右旋糖酐40和氧化聚明胶溶液的清除情况可用开放二室模型最佳描述。由于其更高的异质性，即使假设三个清除常数，中等分子量羟乙基淀粉200/0.5的清除情况也只能大致表征。在前四天，羟乙基淀粉200/0.5的清除速度比右旋糖酐40更快。然而，随后发现约3%的给药羟乙基淀粉200/0.5从血管内空间的清除非常缓慢。氧化聚明胶的清除特别迅速。因此，氧化聚明胶的肾脏清除率最高，这与分子量密切相关。另一方面，快速清除同时伴随着相应较低的容量效应。
