Atemgaswechsel und Glucoseaufnahme der menschlichen Milzin situ

SummaryBlood samples were taken from the splenic artery, vein and pulp of 16 patients suffering from lymphoproliferative diseases, essential thrombocytopenia or hereditary spherocytosis and undergoing early splenectomy. The relevant parameters of the respiratory gas exchange as well as glucose and lactate concentrations were determined in these samples. In no case did the thorough examination of the splenic tissue reveal any histopathologic aspects. Taking into account a mean splenic blood flow of 100 ml/100 g/min during anaesthesia, the mean oxygen consumption of the splenic tissue attains 1.1 ml/100 g/min. The glucose uptake and the lactate release show to be 9 mg/100 g/min and 5.2 mg/100 g/min, respectively. Despite high glucose uptake rates and pronounced glycolytic activities there is no evidence of the existence of low pH values, a glucose depletion or hypoxia in the normal spleen. In the normal spleen, therefore, the intrasplenic sequestration of red blood cells cannot be explained by unfavourable metabolic conditions.ZusammenfassungBei 16 Patienten mit lymphoproliferativen Erkrankungen, mit essentieller Thrombozytopenie oder hereditärer Sphärocytose werden vor der Splenektomie Blutproben aus der Milzarterie, -vene und -pulpa entnommen und die relevanten Parameter des Atemgaswechsels sowie Glucose- und Lactatkonzentrationen bestimmt. Die eingehende Untersuchung der operativ entfernten Milzen zeigte in keinem Fall histopathologische Veränderungen. Unter Zugrundelegung einer mittleren Milzdurchblutung von 100 ml/100 g/min während der Narkose errechnet sich ein mittlerer O2-Verbrauch des Milzgewebes von 1,1 ml/100 g/min. Die Glucose-Aufnahme und die Lactatfreisetzung betragen 9 mg/100 g/min bzw. 5,2 mg/100 g/min. Niedrige pH-Werte und niedrige Glucosekonzentrationen liegen trotz der hohen Glucoseutilisation und ausgeprägten glykolytischen Aktivität in der Pulpa der normalen menschlichen Milz nicht vor. Ebenso finden sich nie Zeichen einer Gewebshypoxie. Ungünstige metabolische Bedingungen dürften demnach in der normalen Milz keine ursächliche Rolle bei der intralienalen Sequestration von Erythrozyten spielen.

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