左心辅助循环对血液流变性的影响

EFFECT OF LEFT VENTRICULAR ASSIST DEVICE ON HEMORHEOLOGY

左心辅助循环（ＬＶＡＤ）是治疗严重左心衰竭的一项重要措施，在临床上起到了显著的效果。然而，左心辅助循环是一种非生理性的体外循环，它对整个机体会产生许多不利，而最直接最严重的是对循环系统的影响。本文采用本所研制的新型左心辅助━━罗叶泵，在动物体内进行模拟应用，研究其对血液流变性的影响。实验动物为山羊，共１０只，平均体重４３．５ｋｇ，分别在转流前及转流后６小时，测定血液流变学各项指标。结果显示：在辅助循环后全血粘度及血浆粘度在切变率为 １．２４３５Ｓ－１、２３Ｓ－１及 １２５Ｓ－１的三种条件均下降；在弹性指标方面，除损失角δ在辅助循环后轻度上升之外，动弹性模量和损耗弹性模量在切变率为０．９７３Ｓ－１、１．７９９Ｓ－１及 １１．３４Ｓ－１三种情况下均降低；红细胞的刚度ＴＫ值上升，在低切变率下与高切变率下全血表观粘度的比值Ａ１以及在低切变率下全血表观度与血浆粘度比值Ａ２均比术前低。以上结果反映了血液对ＬＶＡＤ的急性反应。说明ＬＶＡＤ的早期将对血液流变性产生较大的影响。

Fan Ruixin,Luo Zhengxiang,Ye Chunxiu,Zhang Jingfang Xiao Xuejun,Cheng Anheng,Cui Jianxing,Xu Yueqing Abstruct:left ventricular assist device (LVAD) is one of the most important role for the treatment of severe left heart failure. on the other hand, the LVAD is a mechanical circuatory device, the influence on circulation system is the most direct and sevre. In this paper, a new LAVD-Luo ye pump was used to study the hemorheological changs in vivo. All studies were performed with ten sheep (mean weight 43. 5kg). All the hemorheological parameters were collected at before lvad and six hours after LVAD. The results indicated:1. after LAVD ,blood and plasma viscosity decreased when the shear rate were 1. 243s^(-1) and 125s^(-1) respectively; 2. when shear rate were 0. 973s^(-1). 799s and 11.35s^(-1) the blood viscolasticity decrased ,the storge model G' and loss model G' were very low. in contrast, the loss angle δ had sligthly increased; 3. about the erythocyte aggregation ,the Tk of RBC increased. Both the ratio A_1 ang A_2 were lower after LAVD. These results showed the acute reaction of hemorheology after LVAD and during time of LAVD, the hemorheology would be changed.