新生儿重度窒息的血液流变学变化

The Change of Hemorheology in Newborns with Severe Birth Asphyxia

目的 :探讨重度窒息新生儿血液流变学改变 ,说明其参与组织损伤过程以及川芎嗪注射液治疗对流变学的影响。方法 :重度窒息新生儿 2 9例 ,对照组 10例 ,应用全自动血流变快测仪 ,通过毛细管法测定血液粘度 ,用温氏法测定红细胞压积。结果 :窒息组新生儿治疗前较对照组新生儿高、低切变率下全血粘度均显著升高 (P <0 .0 1) ,红细胞压积 (HCT)两组间无差异 (P >0 .0 5 )。川芎嗪治疗后复查 8例 ,高、低切变率下全血粘度均较治疗前显著下降 (P <0 .0 1) ,HCT也较治疗前下降 (P <0 .0 5 ) ,川芎嗪治疗后与对照组相比 ,高、低切变率下全血粘度无差异 (P >0 .0 5 ) ,HCT明显下降 (P <0 .0 5 )。结论 :重度窒息患儿血液粘度增高 ,可致微循环障碍 ,影响组织灌注 ,参与损伤过程 ,应用川芎嗪可提高红细胞变形能力 ,降低血液粘滞度 。

Objective:To explore the change of blood rheology in newborns with severe birth asphyxia and the effect of treatment with Chuanxiong on the blood rheology. Methods: Blood viscosity was detected with capillary tube method and hematocrit was detected with Wintrobe method in 29 newborns with severe asphyxia and in 10 normal newborns in 2 to 3 days after birth. One week later, 8 cases in the treatment group were examed once again. Results: Blood viscosity in newborns with severe asphyxia was higher than that in the control group ( P <0.01). The difference of hematocrit, however, was not significant( P >0.05). The blood viscosity and hematocrit in newborns with severe asphyxia descended obviously after the remedy with chuanxiong ( P <0.01, P <0.05, respectively). Although the difference of hematocrit was significant between the treatment group and control group ( P <0.05), that of blood viscosity was not ( P >0.05). Conclusion: The increase of blood viscosity in newborns with severe asphyxia may accelerate the obstacle of microcirculation and intensify the damage of brain. The remedy with Chuanxiong may prevent and treat the hypoxic damage of the organs by increasing the changeable ability of red-cell-shape and decreasing the blood viscosity.