Olthof C G, Baars J W, Wagstaff J, Donker A J, Schneider H, de Vries P M
Department of Anaesthesiology, Free University Hospital, Amsterdam, The Netherlands.
Eur J Appl Physiol Occup Physiol. 1993;67(2):168-73. doi: 10.1007/BF00376662.
One of the most common side effects of treatment with recombinant interleukin-2 (IL-2) is capillary leakage. Its genesis is not completely understood. The aim of the study was to determine whether capillary leakage can be monitored by means of a noninvasive conductivity technique and to study its starting point. Eight patients with advanced renal cell cancer were studied in a medium care section of the Department of Medical Oncology, University Hospital over 4 days during treatment sessions of continuous, intravenously administered IL-2 (mean dose of 15.6 x 10(6) IU.m-2.day-1). The fluid shift from the intravascular to the extra- and intracellular compartments was monitored by means of noninvasive conductivity measurements. Changes in blood volume were calculated from serial erythrocyte counts. The clinical parameters of capillary leakage (oliguria, positive fluid balance, and gain in mass) were recorded. The mean gain in mass was 9% after 4 days of IL-2 treatment. The extracellular fluid volume increased significantly [46 (SD 23.2)%; P < 0.01], whereas the intracellular fluid volume did not change. The increase in blood volume (BV) amounted to 7% (P < 0.05). The decline in albumin concentration was significantly more than the increase in BV [38 (SD 4.3)%; P < 0.01], indicating capillary albumin leakage. The main changes were observed after the 2nd day of treatment. From this study, it is suggested that conductivity measurements are a suitable method to monitor capillary leakage induced by IL-2, and could be used to detect the exact onset and severity of this leakage.(ABSTRACT TRUNCATED AT 250 WORDS)
重组白细胞介素 -2（IL -2）治疗最常见的副作用之一是毛细血管渗漏。其发病机制尚未完全明确。本研究旨在确定是否可以通过无创电导率技术监测毛细血管渗漏，并研究其起始点。在大学医院医学肿瘤学系的中级护理病房，对8例晚期肾细胞癌患者进行了为期4天的研究，期间持续静脉注射IL -2（平均剂量为15.6×10⁶IU·m⁻²·天⁻¹）。通过无创电导率测量监测液体从血管内转移到血管外和细胞内间隙的情况。根据连续红细胞计数计算血容量变化。记录毛细血管渗漏的临床参数（少尿、正液体平衡和体重增加）。IL -2治疗4天后平均体重增加9%。细胞外液体积显著增加[46（标准差23.2）%；P < 0.01]，而细胞内液体积未改变。血容量（BV）增加了7%（P < 0.05）。白蛋白浓度的下降明显超过BV的增加[38（标准差4.3）%；P < 0.01]，表明存在毛细血管白蛋白渗漏。主要变化在治疗第2天后观察到。从本研究可知，电导率测量是监测IL -2诱导的毛细血管渗漏的合适方法，可用于检测这种渗漏的确切起始时间和严重程度。（摘要截断于250字）
