Conhaim R L, McGrath A M, Cooler S D, DeAngeles D A, Myers G A, Harms B A
Department of Surgery, University of Wisconsin-Madison, USA.
Am J Respir Crit Care Med. 1997 Mar;155(3):971-7. doi: 10.1164/ajrccm.155.3.9117034.
We tested the hypothesis that plasma oncotic pressure alone, not the plasma-to-lymph oncotic pressure difference, modulates pulmonary transvascular fluid filtration. To do this we measured lung lymph flow after raising left atrial pressure (by inflating a balloon) in sheep that were receiving a continuous (32 h) infusion of dextran 40. For comparison, we also raised left atrial pressure elevation, plasma oncotic pressures in dextran and control sheep, respectively, were 39.5 +/- 4.5 and 17.7 +/- 2.2 mm Hg; plasma-to-lymph oncotic pressure gradients, respectively, were 4.4 +/- 0.6 and 4.4 +/- 0.6 mm Hg. Left atrial pressure elevation during dextran infusion increased lung lymph flow by a factor of 2.4 +/- 0.4, compared with a factor of 4.2 +/- 2.3 in control sheep. Thus, left atrial pressure elevation increased lymph flow less in dextran-treated animals than in control animals, even though the plasma-to-lymph oncotic pressure gradients were equal. This suggests that plasma oncotic pressure alone may be a more important determinant of pulmonary transvascular fluid filtration than the plasma-to-lymph oncotic pressure difference.
我们验证了这样一种假说,即调节肺血管跨膜液体滤过的是血浆胶体渗透压本身,而非血浆与淋巴液之间的胶体渗透压差值。为此,我们在持续(32小时)输注右旋糖酐40的绵羊中,通过充盈气囊升高左心房压力,然后测量肺淋巴流量。作为对照,我们也升高了左心房压力。输注右旋糖酐的绵羊和对照绵羊的血浆胶体渗透压分别为39.5±4.5和17.7±2.2毫米汞柱;血浆与淋巴液之间的胶体渗透压梯度分别为4.4±0.6和4.4±0.6毫米汞柱。输注右旋糖酐期间升高左心房压力使肺淋巴流量增加了2.4±0.4倍,而对照绵羊增加了4.2±2.3倍。因此,尽管血浆与淋巴液之间的胶体渗透压梯度相等,但输注右旋糖酐的动物中升高左心房压力导致的淋巴流量增加幅度小于对照动物。这表明,与血浆与淋巴液之间的胶体渗透压差值相比,血浆胶体渗透压本身可能是肺血管跨膜液体滤过更重要的决定因素。