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从指示剂稀释曲线推导肺微血管血细胞比容

Deduction of pulmonary microvascular hematocrit from indicator dilution curves.

作者信息

Overholser K A, Lomangino N A, Harris T R, Bradley J D, Bosan S

机构信息

Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235.

出版信息

Bull Math Biol. 1994 Mar;56(2):225-47. doi: 10.1007/BF02460641.

Abstract

We have developed a new model describing the relationship between plasma and red cell tracers flowing through the lung. The model is the result of an analysis of the transport of radiolabeled plasma albumin between two flowing phases and shows that differences between red cell and plasma tracer curves are related to microvascular hematocrit. The model was tested in an isolated, blood-perfused dog lung preparation in which we injected 51Cr-labeled red cells and 125I-labeled plasma albumin into the pulmonary artery. From the tracer concentration-time curves at the venous outflow, we calculated hr, the ratio of microvascular hematocrit to large-vessel hematocrit. In 18 baseline experiments, hr = 0.92 +/- 0.01 (mn +/- sem) at a blood flow rate of 10.7 +/- 0.3 ml s-1. We determined the effects of (a) glass bead embolization, (b) alloxan, and (c) lobe ligation on hr. Embolization attenuated the separation between plasma and red cells (increased hr), probably as a consequence of passive vasodilation. Alloxan enhanced separation of plasma and red cells (decreased hr), possibly as a result of arteriolar vasoconstriction. Ligation of a fraction of the perfused tissue at constant flow did not cause significant change in hr in the remaining perfused tissue. The model assumes that large-vessel transit times are uniform and that all dispersion occurs in the microvasculature. A theoretical analysis apportioning dispersion between large and small vessels disclosed that the error associated with these assumptions is likely to be less than 15% of the measured hr. We conclude from this study that the microvascular hematocrit model describes experimental plasma and red cell curves. The results imply that hr can be readily deduced from tagged red cells and plasma and can be accounted for in calculating permeability-surface area in diffusing tracer experiments.

摘要

我们开发了一种新模型,用于描述流经肺部的血浆和红细胞示踪剂之间的关系。该模型是对放射性标记血浆白蛋白在两个流动相之间传输进行分析的结果,表明红细胞和血浆示踪剂曲线之间的差异与微血管血细胞比容有关。该模型在一个分离的、血液灌注的犬肺制备模型中进行了测试,我们将51Cr标记的红细胞和125I标记的血浆白蛋白注入肺动脉。根据静脉流出端的示踪剂浓度-时间曲线,我们计算了hr,即微血管血细胞比容与大血管血细胞比容的比值。在18次基线实验中,血流速度为10.7±0.3 ml s-1时,hr = 0.92±0.01(平均值±标准误)。我们确定了(a)玻璃珠栓塞、(b)四氧嘧啶和(c)肺叶结扎对hr的影响。栓塞减弱了血浆和红细胞之间的分离(hr增加),这可能是被动血管舒张的结果。四氧嘧啶增强了血浆和红细胞的分离(hr降低),可能是小动脉血管收缩的结果。在恒定流量下结扎部分灌注组织,剩余灌注组织中的hr没有显著变化。该模型假设大血管传输时间是均匀的,所有扩散都发生在微血管中。对大小血管之间的扩散进行的理论分析表明,与这些假设相关的误差可能小于测量的hr的15%。我们从这项研究中得出结论,微血管血细胞比容模型可以描述实验性血浆和红细胞曲线。结果表明,hr可以很容易地从标记的红细胞和血浆中推导出来,并且在计算扩散示踪剂实验中的通透表面积时可以予以考虑。

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