阻断冠脉血流后体循环与缺血区局部静脉血液流变学变化的对比研究

The comparative study of the hemorrheologic changes following acute coronary occlusion between the systemic circulation and coronary venous bloodstream

阻断狗冠脉左前降支血流后,缺血区局部静脉血流变特性出现明显、稳定的异常变化。缺血40min时低切变率(r=1.15s^(-1))全血粘度已明显升高(从对照值的39±7.9mPa.s增加到58±8.4mPa.s),这一变化出现在血浆纤维蛋白原浓度与HCT明显变化之前,提示急性心肌缺血早期血液粘度的异常增高除血浆纤维蛋白原与HCT的影响外,可能还有另外一些尚未阐明的快速调节机制参与。缺血区局部血液高切变率下(r=230s^(-1))全血粘度升高程度明显大于体循环静脉血,这可能与缺血区酸性代谢产物蓄积、H^+浓度增高以及氧分压降低有关。

Following acute occlusion of the left anterior desending coronary artery, the significant and constant hemorrheologic changes were observed in blood draining from ischemic area. At the 40-min of occlusion, the tow shear viscosity (r=1.15 s^(-1)) of whole blood increased from the preocclusion value of 39±7.9m Pa.s to 58±8.4 mPa.s (P<0.01) and this change occured before the distinct increase in plasma fibrinogen and hematocrit, suggesting that there may be some other rapid mechanism which resulted in the hemorrheologic changes in the early phase of myocardial ischemia. At high shear rate (r=230 s^(-1)), the increase of viscosity of the blood draining from ischemic area was more significant than that from systemic circulation, this phenomenon may be related to the increase of H^+ concentration resulting from the accumulation of the acid metabolites in the ischemic region and the distinct decrease of partial pressure of oxygen.