系统性硬皮病微循环和血液流变性改变与分析

Changes and Analysis on Microcirculation and Hemorheology in 62 Patients with Progressive Systemic Sclerosis

报道６２例系统性硬皮病的微循环、血液流变性和免疫学改变并分析三者间的关系。提出管袢＂棒状＂扩张的畸变很有特色，对早期诊断和鉴别、分型很有价值。管袢数目减少者占患者的４８．４％，ＲＢＣ聚集９８．１％，流速减慢９８．４％，袢顶出血８０．６％；低和高切变率下ηｂ升高者分别为３４．３％和２２．９％，ηｂ降低者分别为３７．１％和２０％。ηｐ升高者２５．７％，降低者１１．４％；ＡＮＡ阳性者６９．４％，ＩｇＧ３８．７％、补体Ｃ４５９．６％、Ｃ３１９．１％、Ｙ－球蛋白３５．４％升高。统计学表明ＡＮＡ阳性组ηｐ高于ＡＮＡ阴性组，Ｐ＜０．０５。分析认为抗体的产生是血液流变性改变的原因，后者又引起微循环的异常。

It was reported that on changes of microcirculation, hemorheology and immunology in 62 patients with progressive systemic sclerosis (PSS) and to analyse the relationship between the changes of three subjects as mentioned above. It was suggested that the club-like dilated capillary loops in nailfold is very valuable for diagnosis, differential diagnosis and differention of type of PSS. The results showed that the count of capillary loops of nailfold in 48.4% of patients with PSS was diminished, the RBC aggregation in 98.1%. slowed velocity of blood flow in 98. 4% and petechiae round the nailfold capillaries in 80.6% of patients were found; with the shear rate 5.75s-1 and 115s-1, the ηb increased is 34.3% and 22. 9% cases respectively, meanwhile ηb is lowered than that of normal subject in 37. 1% and 20% patients. ηp elevated in 25.7%. dropped in 11. 4% cases with PSS respectively; positive reaction of antinuclear antibody(ANA) in 69.4% patients, IgG in 38.7%, alexin C4 in 59.6%, C3 in 19. 1% and γ-golobulin in 35.4% of patients were elevated. Statistics showed that the ηp in positive reaction of ANA group is higher than that in negative group(P<O.05).It is considered that the production of antibodies is the cause for hemorheological changes, and the later in turn causes the microcirculatory abnormalities.