肺心病急性发作期血液流变学与血气变化探讨

Correlation of Hemorheology and Blood Gas Levels in Acute Attacks of Cor Pulmonale

观察50例肺心病急性发作期患者与对照组80例的血流变学改变,并就前者pH值、PaCO_2、PaO_2改变及酸碱失衡的类型与血流变学变化的关系进行探讨。结果显示:肺心病急性发作期全血粘度、血浆粘度、红细胞压积、血小板计数均增高,全血粘度低切变速度(5.75^(s-1))的增加更明显,纤维蛋白原、血红蛋白、血沉无显著改变。PaO_2下降、PaCO_2升高、pH<7.35时,全血粘度、血浆粘度、红细胞压积均升高,缺氧比二氧化碳潴留更为明显,pH>7.45(碱血症)时,全血粘度、血浆粘度的数值有下降的趋势。

The hemorheologic levels of 50 cases in acute attack of cor pulmonale and 80 normal subjects were investigated. In the former group, the correlation between effects of pH, PaCO2, PaO2 and the types of acid-base disturbances on the hemorheo-logy levels were also studied. The results indicated that the levels of blood and plasma viscosity, hematoorit and platelet count increased, and the lower shear rate of the blood viscosity increased markedly, whereas there were no significant changes on the levels of fibrinogen, hemoglobin and ESR. While PaO2 decreased, PaCO2 increased andpH<7.35, blood and plasma viscosity and hematocrit increased, and hypo-xia was more evident than CO2 retention. When pH>7.45 (alkalemia), blood and plasma viscosity tended to decrease.