実験的異型型輸血の進展と統御に関する研究
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概要
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In incompatible blood transfusion, which is an untoward reaction, urgent treatment is required to prevent disseminated intravascular coagulation (DIC), although a mechanism other than DIC has been reported to be responsible for phenomena associated with incompatible blood transfusion. In the present study, the effect of heparin on experimental incompatible blood transfusion was investigated. Ten ml of anti-sheep blood red cell rabbit serum(the titer was X 5,000 by the agglutination test) was injected into rabbits. At 10 min after antiserum injection, sheep blood red cells (SRBC) (Japan Biotest Laboratory) were injected at constant volume (4 ml). Following the SRBC injection, the blood pressure measured with an electric transducer through a catheter inserted into the femoral artery, dropped, hemolysis and hemoglobinuria appeared, and dyspnea was observed. On autopsy, part of the lung was found to be dark purple or black. Blood analysis at 5, 15, 30 and 60 min after SRBC injection revealed low fibrinogen content, extremely decreased platelet counts (below 20,000/mm^3) and mildly prolonged PTT. These results suggested the presence of DIC during incompatible blood transfusion. The size of the discolored area in the lung and the extent of blood pressure decrease were roughly in parallel with the SRBC count injected. In order to examine the effect of heparin, the SRBC count was adjusted to about 10^7/mm^3, at which concentration control rabbits died within 16 min with a severe blood pressure drop. Pairs of rabbits with almost identical body weight were used ; one as control and the other for heparin administration. The antiserum and SRBC were divided into two and administered to each of the rabbits. In the control group, death occurred at 5-16 min, and autopsy revealed widespread areas of discoloration in the lung. On the other hand, heparin administered rabbits survived for more than 60 min (4 cases). One rabbit actually died at. 16 min but the control rabbit of this pair died at 5 min. On autopsy, rather clear lungs were observed in most cases of heparin administration. The life-prolonging effect of heparin after experimental incompatible blood transfusion in rabbits thus supports the presence of DIC. It also indicates a clinical use for heparin cases of incompatible b.lood transfusion.
- 神戸大学の論文