风湿性心脏病心衰患者血液粘弹特性的改变

Viscoelastic Property Alterations in Patients with Rheumatic Heart Disease and Congestive Heart Failure

本文报道63例不同心功(NYHA分级)风心病患者的高、中、低切变率全血表观粘度和血液粘弹性改变及其与同期脉冲多普勒超声心功能的相关关系。结果显示:与Ⅰ级心功组比较,Ⅱ级心功组无血液粘弹特性改变,Ⅲ、Ⅳ级心功组除血浆粘度(ηp)外,其余所测血液粘弹特性指标均有改变,且与PDE左室每搏量、心输出量、峰值血流速度等心功能参数呈负相关,其中以低切变率下全血表观粘度(η_(0. 512)),红细胞聚集指数及复粘度的弹性分量η″与心功关系较密切。

Few papers on alterationof whole blood viscoelastie properties inpatients with congestive heart failure(CHF)have been reported. In this studyviscoelastic property parameters weremeasured in 63 consecutive patients withrheumatic heart disease and CHF. Allsubjects were divided into four groupsaccording to NYHA classification of heartfunction. There were 14 class Ⅰ, 16 class Ⅱ20 class Ⅲ and 13 class Ⅳ. Contraves low-shear-30 rheometer was used for measur-ing the viseoelastic parameters. The resu-lts demonstrated that there was no significant difference of these parameters between class Ⅰ and class Ⅱ, that the apparentviscosity, AI and η′in class Ⅲ were higherthan those in class Ⅰ, and thatη_(0.512),η_(5.96)AI, η′,η″and G′in class Ⅲ werehigher than thooe in class Ⅱ. All viscoelas-tic parameters but ηp in class Ⅳ weremarkedly higher than those in othergroups. However, there were no statisti-cally significant difference of ηp amongall subjects and nor significant differenceof these parameters between male andfemale were noted. There was a nega-tive correlation between viscoelasticparameters and heart function parametersby pulse Doppler echocardiography (peakflow velocity. stroke volume and card-iac output). The results also showed asignificant direct correlation between η_(0.512)AI, and η″ and the heart function para-meters mentioned above.