Manning R D
Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi 39216-4505, USA.
Am J Physiol. 1998 Dec;275(6):R1878-84. doi: 10.1152/ajpregu.1998.275.6.R1878.
The dynamics of fluid volume distribution between the blood and interstitium during hyperproteinemia were studied in 12 anephric, conscious dogs during several states of hydration. After recovery from splenectomy and unilateral nephrectomy, plasma protein concentration was elevated to 8.4-8.7 g/dl by daily intravenous infusion of 330 ml of previously collected autologous plasma for 11 days. The remaining kidney was then removed, and the next day lactated Ringer solution equivalent to 10 or 20% of body weight was infused intravenously. By the end of the 25-h postinfusion period, Ringer infusion had increased circulating protein mass 20.9 +/- 9.1% (mean +/- SE) in the 10% group (P < 0.05) and decreased it 10.5 +/- 3.3% in the 20% group (P < 0.05). The average increase in blood volume and arterial pressure during the postinfusion period was 27.4 +/- 2.5 and 20.7 +/- 3.7%, respectively, in the 10% group but only 17.8 +/- 2.4 and 12 +/- 1.6% in the 20% group (all changes significant compared with respective control). The relationship between blood volume and sodium space was similar to that found during normoproteinemia, such that elevations in sodium space of 40-50% increased blood volume but greater elevations in sodium space caused no further increases in blood volume. Overhydration during chronic hyperproteinemia causes hypervolemia and hypertension, but, in contrast to those in short-term studies, the increases in blood volume and arterial pressure are not greater than those achieved during normoproteinemia.
在12只去肾的清醒犬处于几种不同的水合状态时，研究了高蛋白血症期间血液与间质之间液体容量分布的动态变化。在脾切除和单侧肾切除恢复后，通过每日静脉输注330ml先前采集的自体血浆，持续11天，使血浆蛋白浓度升高至8.4 - 8.7g/dl。然后切除剩余的肾脏，次日静脉输注相当于体重10%或20%的乳酸林格液。在输注后25小时结束时，在10%组中，林格液输注使循环蛋白量增加了20.9±9.1%（平均值±标准误）（P<0.05），而在20%组中使其减少了10.5±3.3%（P<0.05）。在输注后期间，10%组的血容量和动脉压平均增加分别为27.4±2.5%和20.7±3.7%，而20%组仅为17.8±2.4%和12±1.6%（与各自的对照组相比，所有变化均具有显著性）。血容量与钠间隙之间的关系与正常蛋白血症期间发现的关系相似，即钠间隙升高40 - 50%会增加血容量，但钠间隙进一步升高不会导致血容量进一步增加。慢性高蛋白血症期间的水过多会导致血容量过多和高血压，但与短期研究不同的是，血容量和动脉压的增加并不大于正常蛋白血症期间的增加。
