体内注射英脱利匹特对新生儿和幼儿的血黏度及其他血液流变学参数的影响  

Effects of intralipid infusion on blood viscosity and other haemorheological parameters in neonates and children

作　　者：Kessler U. Poeschl J. Raz D. O.Linderkamp 李开 

机构地区：[1]Division of Neonatology, Department of Paediatrics, University of Heidelberg,Im Neuenheimer Feld 153,DE -69120 Heidelberg, Germany

出　　处：《世界核心医学期刊文摘（儿科学分册）》2005年第3期11-12,共2页

摘　　要：目的:以早产儿、足月新生儿和幼儿为对象,研究其体内注射英脱利匹特后血液流变学的改变情况。现已知,英脱利匹特引起的循环系统并发症,如肺循环和体循环血流阻力增加,与血液流变学变化有关。方法:收集处于全胃肠外营养期的病例,分成早产儿组、足月儿组和幼儿组,每组均为10例,给予初始剂量的英脱利匹特后,间隔4 h再次输注(0.6 g/kg)。另外,采取10例健康早产儿、10例足月新生儿和10例成人的血液样本,用英脱利匹特进行试管培养。英脱利匹特输注前后,以及用英脱利匹特进行试管血液培养前后,分别检测全血黏度和血浆黏度(用毛细血管黏度计测定),红细胞(RBC)Aim: To study acute haemorheological effects of intralipid in preterm and full-term neonates and children. Circulatory complications of intralipid infusion, such as increases in pulmonary and peripheral flow resistance, have been associated with impaired blood rheology. Methods: During total parenteral nutrition, 10 preterm infants, 10 full-term neonates and 10 children received an initial dose of intralipid as continuous infusion (0. 6 g/kg) over 4 h. Additionally, blood of 10 healthy preterm infants, 10 full-term neonates and 10 adults was incubated with intralipid. Whole blood and plasma viscosity (capillary vis-cometer), red blood cell (RBC) deformability (rheoscope) and RBC aggregation (Myrenne aggregometer) - were measured before and after intralipid infusion and before and after in vitro incubation of blood with intralipid. Results: During intralipid infusion, plasma triglyceride levels increased from 0. 13 ±0. 27 to 2. 16 ±0. 68 g/l in the preterm infants, from 0. 14 ± 0. 21 to 1. 64 ± 0. 54 g/1 in the full-term neonates and from 0. 65 ± 0. 31 to 2. 26 ± 0. 60 g/l in the children. Whole blood viscosity decreased by about 10% after intralipid in all three groups due to similar decreases in haematocrit. RBC aggregation decreased by about 20% after intralipid infusion. Plasma proteins, plasma viscosity and RBC deformation were not affected by intralipid. In vitro incubation of blood with intralipid resulted in a marked reduction of RBC aggregation that was related to the intralipid concentration. At in-tralipid concentrations of 4 and 8mg/ml, no RBC aggrega-tionwas noted in preterm and full-term neonates. In adults, RBC aggregation decreased by 50%. Conclusions: Previously described deleterious effects of intralipid on circulation can not be explained by changes in haemorheological properties.

关 键 词：英脱利匹特 血液流变学参数 血黏度 血液流变学变化 体内注射 血液培养 血液样本 系统并发症 试管培养 全胃肠外营养 

分 类 号：R96[医药卫生—药理学]