Duncan A, Young D S
Clin Chem. 1982 Jan;28(1):141-5.
We examined the usefulness of serum colloid osmotic pressure measurement in patients with chronic rather than acutely occurring low serum protein concentrations. We used two oncometers, the IL 186 Weil Oncometer and the Wescor Model 4100; results from the two instruments were interchangeable. Values for the colloid osmotic pressure were compared with those for serum total protein (r = 0.783) and albumin concentrations (r = 0.882), which were similar to previously published values. Our day-to-day CV was 2.8%. In studying over 100 patients we found that the previously reported occurrence of pulmonary edema in almost all patients whose colloid osmotic pressure was less than 12.5 mmHg was not seen in the chronic hypoproteinemic patients. We noted only one fatality in our patients whose colloid osmotic pressure was less than 10.5 mmHg, a value found to be associated with fatality in one previous study of acutely ill patients. Factors such as ambulation, fasting, dehydration, and the nature of the blood sample can markedly affect the value for colloid osmotic pressure value, and this, coupled with the good correlation with the serum albumin in several studies, leads us to question the usefulness of measuring colloid osmotic pressure in a non-specialist hospital environment, either as an adjunct to the measurement of serum protein or albumin, or as an independent test.
我们研究了血清胶体渗透压测量在慢性而非急性出现低血清蛋白浓度患者中的实用性。我们使用了两种渗透压计，即IL 186 Weil渗透压计和Wescor 4100型；两种仪器的结果可互换。将胶体渗透压值与血清总蛋白值（r = 0.783）和白蛋白浓度值（r = 0.882）进行比较，这些值与先前发表的值相似。我们的日常变异系数为2.8%。在对100多名患者的研究中，我们发现，在慢性低蛋白血症患者中，并未出现先前报道的几乎所有胶体渗透压低于12.5 mmHg的患者都会发生肺水肿的情况。在我们的患者中，胶体渗透压低于10.5 mmHg的患者仅出现1例死亡，在先前一项对急性病患者的研究中发现该值与死亡相关。诸如活动、禁食、脱水和血样性质等因素可显著影响胶体渗透压值，再加上多项研究中其与血清白蛋白的良好相关性，这使我们质疑在非专科医院环境中测量胶体渗透压的实用性，无论是作为血清蛋白或白蛋白测量的辅助手段，还是作为一项独立检测。
