Solomon R A, Post K D, McMurtry J G
Neurosurgery. 1984 Sep;15(3):354-61. doi: 10.1227/00006123-198409000-00010.
The result of 42 blood volume determinations made with autologous red blood cells labeled with chromium-51 are reported. The subjects consisted of 11 control patients and 25 patients with recent subarachnoid hemorrhage (SAH). The mean red blood cell volume (RBCV) and the total blood volume (TBV) for female patients after SAH were significantly lower than corresponding control values (P less than 0.01). No depression of blood volume was found in males as a group. Seventy-two per cent of females had below-normal RBCV and 50% had below-normal TBV. Fifteen patients demonstrated angiographic vasospasm or signs of cerebral ischemia. Only 1 patient with asymptomatic vasospasm had a below-normal RBCV or TBV, whereas 6 of 7 patients with symptomatic vasospasm had a subnormal RBCV or TBV. The mean RBCV and mean TBV for female patients with symptomatic vasospasm were significantly lower than corresponding control values (P less than 0.02) and lower than values for female patients with asymptomatic vasospasm (P less than 0.05). The data suggest that volume status may be the important differential between asymptomatic and symptomatic vasospasm. Delayed ischemic deficits can be expected to develop in patients who have both spasm of the intracranial vessels and decreased TBV. Patients with normal blood volume are far less likely to experience cerebral ischemia, even if vasospasm develops.
报告了用铬-51标记的自体红细胞进行42次血容量测定的结果。受试者包括11名对照患者和25名近期蛛网膜下腔出血（SAH）患者。SAH后女性患者的平均红细胞体积（RBCV）和总血容量（TBV）显著低于相应的对照值（P<0.01）。总体而言，男性未发现血容量降低。72%的女性RBCV低于正常，50%的女性TBV低于正常。15名患者表现出血管造影血管痉挛或脑缺血迹象。只有1名无症状血管痉挛患者的RBCV或TBV低于正常，而7名有症状血管痉挛患者中有6名RBCV或TBV低于正常。有症状血管痉挛女性患者的平均RBCV和平均TBV显著低于相应的对照值（P<0.02），且低于无症状血管痉挛女性患者的值（P<0.05）。数据表明，血容量状态可能是无症状和有症状血管痉挛之间的重要差异。颅内血管痉挛且TBV降低的患者预计会出现延迟性缺血性神经功能缺损。血容量正常的患者即使发生血管痉挛，发生脑缺血的可能性也小得多。
