老年期和老年前期缺血性脑血管病患者白细胞流变学对比观察

A comparative study of leukocyte rheology in presenile and senile patients with ischemic cerebrovascular diseases

用核孔膜滤过法分别对４６例急性脑梗塞、３６例脑动脉硬化和３４例健康者的白细胞总数及白细胞流变学进行了对比观察，每组又分为老年期和老年前期组进行对比。结果显示：白细胞总数、白细胞滤过堵塞的粒子浓度及变形指数，脑梗塞组较健康组明显增高，脑动脉硬化组较健康组也有增高趋势；而各组老年期与老年前期组比较，差异无显著性。提示白细胞流变学异常在脑梗塞发病过程中具有重要作用，而老年期与老年前期二组的年龄差异对白细胞流变学影响不大。Ｐ＜０．０１组内老年与老年前期比较，Ｐ均＞０．０５讨论有人研究证明，白细胞因功能和结构上的特点，其内粘度高于红细胞近２０００倍，且大而硬，因此白细胞对微循环血流影响较大［２］。有人报道脑梗塞患者白细胞的多少与临床表现的严重程度密切相关（Ｐ＜０．０１）．白细胞增多明显者症状重，ＣＴ显示的梗塞面积也相应较大［３］。有人报道，由于白细胞较红细胞大而硬，通过毛细血管时变形较慢，从而使微血管内血液流动阻力增加；但在正常状态下这仅是暂时现象，白细胞对毛细血管的堵塞不引起组织血供和营养障碍，而在脑梗塞时，白细胞对毛细血管的堵塞时间延长甚至呈持续性，从而影响微循环的通畅及侧枝循环的建立，导致全身或局部的低灌流状态?

Abstract Leukocyte rheology was measured with pore membrane filter method in 46 patients with acute cerebral infarction,36 patients with cerebral arteriosclerosis and 34 healthy subjects as control.They were further divided into senile groups and presenile groups according to criterion for old age.Leucocyte count was also done in all of them.Tbe results indicated that the total number of leukocytes particle concentration of leukocyte filter and leukocyte deformity index in the patients groups increased significantly as compared with the controls.Although these parameters tended to increase in cerebral arteriosclerosis,yet there has no significant difference between the presenile and senile groups.It is suggested that abnormal leukocyte rheology is important in the pathogenesis Of acute cerebral infarction and leukocyte rheology is not affected significantly by aging.