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6%羟已基淀粉130/0.4临床应用的研究进展 被引量：3

Clinical Application Progress of 6%HES130/0.4
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摘要 6%羟已基淀粉130/0.4(6%HES130/0.4)是目前应用于临床的新型中分子羟已基淀粉,因相对分子质量范围窄,取代级低(0.4),具有代谢率高,扩容效果好,在组织中蓄积量小的特点。且具有:①对血流动力学改善作用优于容量治疗的"金标准"白蛋白。②具有抗炎作用,其机制来自于它能够抑制白细胞激活,及通过抑制核因子κB来降低炎性反应,还具有减少内皮细胞的损伤,抑制黏附因子释放等途径达到抗炎作用。③对凝血功能的影响仍存在争议,但合理应用,可以避免不良影响。④对肾功能有改善作用,但也有不同观点。⑤毛细血管的封闭效应。 6% HES 130/0.4 is the newest HES with middle molecule used in clinic, his molecular weight distribut is the narrowest of all HES producte. Because its relative molecular mass is narrow with low grade about 0.4, it also has some features of high metabolism, good effect of fluid expansion and little accumulation in tissues. Its effects lies in several aspects, for example, ①6% HES130/0.4 has better effect in promoting hemodynamics than that of gold standard-albumin used in treating low capacity. ②6% HES130/0.4 also has effect of anti-inflammation, its mechanism maybe result from several pathways, such as inhibiting the activation of white blood cells, lowering the inflammation by inhibiting nuclear factor-κB, decreasing the endothelial injury,inhibiting the releasing of adhesion molecules ans so on. ③There are still contraversory about its effects on coagulation, but rational application in clinic can avoid its side effect on coagulation. ④6% HES130/0.4 can improve renal function although there are still some disagreements. ⑤6% HES130/0.4 has blocking effect on blood capillary.
作者 潘四新 薛玉良 马维根
机构地区 天津儿童医院麻醉 泰达国际心血管医院麻醉科
出处 《医学综述》 2008年第14期2182-2185,共4页 Medical Recapitulate
关键词 6%羟已基淀粉130/0.4 血流动力学 炎性反应 凝血 肾 6 % hydroxyethyl starch 130/0.4 Hemodynamics Inflammation Coagulation Kidney
分类号 R614 [医药卫生—麻醉学]
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参考文献30

  • 1James MF,Latoo MY, Mythen MG, et al. Plasma volume changes associated with two hydroxyethyl starch colloids following acute hypovolaemia in volunteers [ J ]. Anaesthesia,2004,59 ( 8 ) :738-742.
  • 2Langeron O, Doelberg M,Ang ET,et al. Voluven, a lower substituted novel hydroxyethyl starch (HES130/0.4 ), causes fewer effects on coagulation in major orthopedic surgery than HES200/0.5 [ J ]. Anesth Analg,2001,92 (4) : 855-862.
  • 3Jungheinrich C,Scharpf R, Wargenau M, et al. The pharmacokinetics and tolerability of an intravenous of the new hydroxyethyl starchl30/0.4 ( 6%, 500ml ) in mild-to-severe renal impairment [ J ]. Anesth Analg,2002,95 ( 3 ) :544-551.
  • 4Palumbo D, Servillo G, D'Amato L, et al. The effects of hydroxyethyl starch slolution in critically ill patients [ J 1. Minerva Anestesiol, 2006,72(7/8) :655-664.
  • 5Gallandat Huet RC, Siemons AW, Baus D ,et al. A novel hydroxyethyl starch(Voluven) for effective perioperative volume substitution in cardiac surgery[J]. Can J Anaesth,2000,47(12) :1207-1215.
  • 6Nielsen VG. Antitthrombin efficiency is maintained in vitro in human plasma following dilution wiith hydroxyethyl starch [ J ]. ecds [ J] Blood Coagul Fibrinolysis,2005,16(5 ) :319-322.
  • 7Fries D, Immerhofer P, Klingler A, et al. The effect of the combined administration of colloids and lactated Ringer'ssolution on the coagulation system:an in vitro study using thrombelastograph coagu- lation analysis ( ROTEG ) [ J ]. Anesth Analg, 2002,94 ( 5 ) : 1280-1287.
  • 8Petroianu GA, Liu J, Maleck WH, et al. The effect of in vitro hemodilution with gelatin, dextran, hydroxyethyl starch or Ringer's solution on thrombelastograph [ J]. Anesth Analg, 2000,90 ( 4 ) : 795 -800.
  • 9Haisch G, Boldt J, Krebs C, et al. The influence of intravascular volume therapy with a new hydroxyethyl starch preparation ( 6% HES130/0.4 )on coagulation in patients undergoing major abdominal surgery[ J].Anesth Analg,2001,92(6) :565-571.
  • 10Entholzner EK, Mielke LL, Calatzis AN, et al. Coagulation effect of a recently developed hydroxyethyl starch(HES130/0.4) compared to hydroxyethyl starches with higher molecular weight [ J ]. Acta Anaesthesiol Scand ,2000,44(2) : 1116-1121.

二级参考文献17

  • 1Hoffmann JN, Vollmar B, Laschke MW, et al. Hydroxyethyl starch (130 kD), but not crystalloid volume support, improves microcirculation during normotensive endotoxemia. Anesthesiology, 2002,97 : 460-470.
  • 2Tian J, Lin X, Guan R, et al. The effects of hydroxyethyl starch on lung capillary permeability in endotoxic rats and possible mechanisms. Anesth Analg ,2004,98:768-774.
  • 3Tian J, Lin X, Zhou W, et al. Hydroxyethyl starch inhibits NF-kappaB activation and prevents the expression of inflammatory mediators in endotoxic rats. Ann Clin Lab Sci, 2003,33. 451-458.
  • 4Lv R, Zhou W, Chu C, et al. Mechanism of the effect of hydroxyethyl starch on reducing pulmonary capillary permeability in a rat model of sepsis. Ann Clin Lab Sci,2005,35: 174-183.
  • 5Lv R, Zhou W, Yang J J, et al. Hydroxyethyl starch inhibits intestinal production of cytokines and activation of transcription factors in endotoxaemic rats. J Int Med Res, 2005,33 : 379- 388.
  • 6Lv R, Zhou W, Zhang LD, et al. Effects of hydroxyethyl starch on hepatic production of cytokines and activation of transcription factors in lipopolysaccharide-administered rats. Acta Anaesthesiol Scand,2005 ,49 :635-642.
  • 7Lv R, Zhou ZQ, Wu HW, et al. Hydroxyethyl starch exhibits antiinflammatory effects in the intestines of endotoxemic rats. Anesth Analg,2006,103 : 149-155.
  • 8Feng X, Yan W, Liu X, et al. Effects of hydroxyethyl starch 130/0.4 on pulmonary capillary leakage and cytokines production and NF-kappaB activation in CLP-Induced sepsis in rats. J Surg Res,2006,In press.
  • 9Pascual JL, Ferri LE, Chaudhury P, et al. Hemorrhagic shock resuscitation with a low molecular weight starch reduces neutrophil-endothelial interactions and vessel leakage in vivo. Surg Infect (Larchmt), 2001,2:275-287; discussion 87-88.
  • 10Dieterich HJ, Weissmuller T, Rosenberger P, et al. Effect of hydroxyethyl starch on vascular leak syndrome and neutrophil accumulation during hypoxia. Crit Care Med, 2006,34: 1775-1782.

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医学综述
2008年 第14期

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