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等渗盐水和羟乙基淀粉溶液对临床正常小马的胶体渗透压、血液稀释及止血作用

Oncotic, hemodilutional, and hemostatic effects of isotonic saline and hydroxyethyl starch solutions in clinically normal ponies.

作者信息

Jones P A, Tomasic M, Gentry P A

机构信息

Department of Clinical Studies, School of Veterinary Medicine, New Bolton Center, University of Pennsylvania, Kennett Square 19348-1692, USA.

出版信息

Am J Vet Res. 1997 May;58(5):541-8.

PMID:9140565
Abstract

OBJECTIVE

To evaluate the oncotic, hemodilutional, and hemostatic effects of IV infusions of a large volume of isotonic saline solution and 2 doses of 6% hydroxyethyl starch (HES) in clinically normal ponies.

ANIMALS

12 adult ponies.

PROCEDURE

Ponies were assigned to 3 treatment groups and received the following IV infusions: 80 ml of 0.9% sodium chloride/kg; 10 ml of 6% HES (in 0.9% sodium chloride)/kg; or 20 ml of 6% HES (in 0.9% sodium chloride)/kg. Blood samples were collected for determination of colloid oncotic pressure (COP), PCV, plasma total protein concentration, platelet count, von Willebrand factor antigen (vWf:Ag) activity, fibrinogen concentration, prothrombin time, activated partial thromboplastin time (APTT), and factor VIII coagulant (FVIII:C) activity. A rocket immunoelectrophoretic procedure was used for determination of vWf:Ag activity. A modification of the APTT assay was used for determination of FVIII:C activity. Cutaneous bleeding time was determined, using a template method.

RESULTS

Mean COP was persistently increased over baseline values in the face of hemodilution in HES-treated ponies. Prothrombin time, APTT, and fibrinogen concentrations decreased after infusions and vWf:Ag and FVIII:C activities were decreased in dose-dependent manner in HES-treated ponies. Though cutaneous bleeding time was not significantly affected in ponies of any group, a trend toward prolongation of bleeding time was evident in ponies receiving 20 ml of HES/kg. This trend appeared to be associated with marked decrement in vWf:Ag activity at this dosage.

CONCLUSIONS AND CLINICAL RELEVANCE

Infusion of HES in clinically normal ponies increases COP, and exerts dose-dependent hemodilutional effects and dose-dependent effects on specific hemostatic variables. Thus, HES may be useful for resuscitative fluid treatment of horses.

摘要

目的

评估静脉输注大量等渗盐溶液和2种剂量的6%羟乙基淀粉(HES)对临床正常小马的胶体渗透压、血液稀释及止血作用。

动物

12匹成年小马。

方法

将小马分为3个治疗组,分别接受以下静脉输注:80 ml 0.9%氯化钠/kg;10 ml 6% HES(溶于0.9%氯化钠)/kg;或20 ml 6% HES(溶于0.9%氯化钠)/kg。采集血样以测定胶体渗透压(COP)、红细胞压积(PCV)、血浆总蛋白浓度、血小板计数、血管性血友病因子抗原(vWf:Ag)活性、纤维蛋白原浓度、凝血酶原时间、活化部分凝血活酶时间(APTT)及因子VIII促凝活性(FVIII:C)。采用火箭免疫电泳法测定vWf:Ag活性。采用改良的APTT测定法测定FVIII:C活性。使用模板法测定皮肤出血时间。

结果

在接受HES治疗的小马中,尽管存在血液稀释,但平均COP持续高于基线值。输注后凝血酶原时间、APTT及纤维蛋白原浓度降低,且在接受HES治疗的小马中,vWf:Ag和FVIII:C活性呈剂量依赖性降低。尽管任何组的小马皮肤出血时间均未受到显著影响,但接受20 ml HES/kg的小马有出血时间延长的趋势。这种趋势似乎与该剂量下vWf:Ag活性的显著降低有关。

结论及临床意义

在临床正常小马中输注HES可增加COP,并对血液稀释及特定止血变量产生剂量依赖性作用。因此,HES可能有助于马匹的复苏液体治疗。

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