Friedman-Mor Z, Chalon J, Gorstein F, Turndorf H, Chuba J V, Orkin L R
J Trauma. 1978 Feb;18(2):104-7. doi: 10.1097/00005373-197802000-00005.
Allegedly toxic heme pigments have been described in the serum of animals bled to hemorrhagic shock (5,7). In addition, Sears et al. (9), and Braun et al. (1) have shown that the products derived from the degradation of hemoglobin following intravascular hemolysis were toxic (heme carried by hemopexin and albumin). The accumulation of metabolites, caused by the impeded circulation, degrades free hemoglobin into heme pigments and their concentration then reaches a level which exceeds the normal heme-carrying capacity of serum proteins. We have already demonstrated the presence of abnormal heme pigments in clinical cases of shock using scanning spectrophotometry (3). We have endeavored to identify these pigments by serum electrophoresis, and to relate the appearance of some of these compounds to mortality rates. There were no deaths associated with the presence of haptoglobin-hemoglobin alone in serum. As shock deepened and mortality rose, hemopexin-heme and methemalbumin appeared. The highest mortality rate (4 out of 5 cases) was found when both hemopexin-heme and methemalbumin were present. It appears, therefore, that the administration of serum proteins in shock may reduce the toxicity of the products of degradation formed in low-flow states.
据称，在因出血性休克而失血的动物血清中发现了具有毒性的血红素色素（5,7）。此外，西尔斯等人（9）以及布劳恩等人（1）已经表明，血管内溶血后血红蛋白降解产生的产物具有毒性（血红素结合蛋白和白蛋白携带的血红素）。循环受阻导致代谢产物积累，使游离血红蛋白降解为血红素色素，其浓度随后达到超过血清蛋白正常血红素携带能力的水平。我们已经使用扫描分光光度法在休克临床病例中证明了异常血红素色素的存在（3）。我们努力通过血清电泳来鉴定这些色素，并将其中一些化合物的出现与死亡率联系起来。血清中仅存在触珠蛋白 - 血红蛋白与死亡无关。随着休克加重和死亡率上升，出现了血红素结合蛋白 - 血红素和高铁血红蛋白。当血红素结合蛋白 - 血红素和高铁血红蛋白同时存在时，发现了最高死亡率（5例中有4例）。因此，似乎在休克时给予血清蛋白可能会降低低流量状态下形成的降解产物的毒性。
