Albumin to ascites: demonstration of a direct pathway bypassing the systemic circulation.
Albumin to ascites: demonstration of a direct pathway bypassing the systemic circulation.
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白蛋白至腹水：演示绕过体循环的直接途径。
DOI：
10.1172/jci106173
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发表时间：
1969
期刊：
影响因子：
--
通讯作者：
M. Rothschild
中科院分区：
文献类型：
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作者：
D. Zimmon;M. Oratz;R. Kessler;S. Schreiber;M. Rothschild
本文研究了8例肝硬化腹水患者血浆白蛋白和新生成白蛋白向腹水的转运。2例患者行胸导管插管，2小时内收集淋巴液，同时静脉注射白蛋白-（131）I和碳酸盐-（14）C。白蛋白-（131）I测定血浆白蛋白向腹水和胸导管淋巴液的转移。通过标记新形成的白蛋白，碳酸-（14）C可以估计新形成的白蛋白转移到血浆、腹水和淋巴中。如果进入腹水和胸导管淋巴液的新合成白蛋白最初进入血浆，则腹水和淋巴液中白蛋白-（14）C和-（131）I的比例与血浆中白蛋白-（14）C和-（131）I的含量的比例相同。然而，如果一些新形成的白蛋白直接进入腹水或淋巴，白蛋白-（14）C在淋巴或腹水中的比例将高于白蛋白-（131）I。在腹水或淋巴中发现的两种标记白蛋白的比率表示为总血浆池的百分比。在研究的8例患者中，血浆中4.2-11.7%的白蛋白-（14）C在2小时内出现在腹水中，而在同一时期，血浆中只有0.4-2.2%的白蛋白-（131）I进入腹水。在研究的两名患者中，在胸导管淋巴引流期间，6.1%和13.5%的新生成白蛋白-（14）C在2小时内出现在淋巴中，而血浆白蛋白-（131）I仅在淋巴中发现2.8%和3.8%。在肝硬化腹水患者中，一些新形成的白蛋白从肝脏绕过体循环直接进入腹水和胸导管淋巴液。
The transport of plasma albumin and newly made albumin into ascitic fluid was studied in eight patients with cirrhosis and ascites. The thoracic duct was cannulated in two patients and lymph collected over a period of 2 hr. Simultaneously albumin-(131)I and carbonate-(14)C were injected intravenously. The albumin-(131)I measured the transfer of plasma albumin into ascites and into thoracic duct lymph. The carbonate-(14)C, by labeling newly formed albumin, permitted the estimation of the transfer of newly formed albumin into plasma, ascites, and lymph. If the newly synthesized albumin entering ascites and thoracic duct lymph is delivered initially into the plasma, then the ratios of the albumin-(14)C and -(131)I in ascites and lymph compared with the content of albumin-(14)C and -(131)I in plasma would be identical. However, if some newly formed albumin is delivered directly into ascites or lymph, the ratio for albumin-(14)C would be higher than that for albumin-(131)I in lymph or ascites. The ratios of both labeled albumins found in ascites or lymph are expressed as per cent of the total plasma pool. In the eight patients studied 4.2-11.7% of the albumin-(14)C in plasma was found in ascites in 2 hr whereas only 0.4-2.2% of plasma albumin-(131)I entered in this same period. In the two patients studied during thoracic duct lymph drainage 6.1 and 13.5% of newly made albumin-(14)C appeared in lymph in 2 hr whereas only 2.8 and 3.8% of plasma albumin-(131)I was found in the lymph. In cirrhosis with ascites some newly formed albumin entered ascites and thoracic duct lymph by a direct pathway from the liver bypassing the systemic circulation.