Mortelmans Y, Merckx E, van Nerom C, Verbruggen A, van Aken H, de Roo M, Mortelmans L
Department of Anaesthesiology, U.Z. Gasthuisberg, Leuven, Belgium.
Eur J Anaesthesiol. 1995 May;12(3):259-64.
The effect of an equal volume replacement with 6% low molecular weight (200,000) hydroxyethyl starch (substitution ratio 0.60-0.66) (Elohaes) on the blood volume and plasma volume of eight healthy volunteers was investigated with special attention to volume overshooting. After replacement of 500 mL whole blood, blood volume was measured repeatedly for 8 1/2 h using chromium-51 labelled erythrocytes. Red cell volume and plasma volume were calculated from standard formulae. After replacement, blood and plasma volumes were unchanged from control (4754 +/- 630 mL and 2900 +/- 450 mL, respectively). The haematocrit decreased from 43.7 +/- 2.5% to 39.0 +/- 1.4% (1 h after starch infusion) and 41.1 +/- 1.9% (7.5 h after starch infusion). There were no significant changes in haemodynamic variables (systolic and diastolic blood pressure; heart rate), liver function (bilirubin; transaminases), renal function (serum creatinine; serum sodium) or coagulation (activated partial thromboplastin time). Alpha-amylase was significantly increased, which is a well known effect of starches. The replacement of 500 mL whole blood by hydroxyethyl starch maintains isovolaemia for at least 8 h in normal volunteers without any significant volume overshooting; this is not what was seen in earlier studies. This should increase safety in patients with cardiac disease.
研究了用6%低分子量（200,000）羟乙基淀粉（取代率0.60 - 0.66）（贺斯）等量置换对8名健康志愿者血容量和血浆容量的影响，特别关注容量过冲情况。在置换500 mL全血后，使用铬-51标记的红细胞对血容量进行了8个半小时的重复测量。红细胞容量和血浆容量由标准公式计算得出。置换后，血容量和血浆容量与对照相比无变化（分别为4754±630 mL和2900±450 mL）。血细胞比容从43.7±2.5%降至39.0±1.4%（淀粉输注后1小时）和41.1±1.9%（淀粉输注后7.5小时）。血流动力学变量（收缩压和舒张压；心率）、肝功能（胆红素；转氨酶）、肾功能（血清肌酐；血清钠）或凝血功能（活化部分凝血活酶时间）均无显著变化。α-淀粉酶显著升高，这是淀粉的一个众所周知的作用。羟乙基淀粉置换500 mL全血可使正常志愿者至少8小时维持等容状态，且无任何显著的容量过冲现象；这与早期研究结果不同。这应可提高心脏病患者的安全性。
