急性心肌梗塞、急性脑梗塞及糖尿病患者红细胞变形能力的研究

Study of erythrocyte deformability in patients with acute myocardial infarction,acute cerebral infarction and diabetes mellitus/

目的：探讨急性心肌梗塞（ＡＭＩ）、急性脑梗塞（ＡＣＩ）及糖尿病（ＤＭ）患者的发病与血液流变学中红细胞变形能力（ＲＣＤ）的变化关系。方法：采用德国ＦＭ４红细胞过滤仪，检测ＡＭＩ、ＡＣＩ及ＤＭ患者的ＲＣＤ。结果：ＡＭＩ、ＡＣＩ及ＤＭ３组患者的ＲＣＤ的最小余量明显高于对照组（Ｐ均＜０．０１），斜明显低于对照组。ＡＭＩ发病２４小时内的ＲＣＤ最小余量明显高于治疗２周后的ＲＣＤ的最小余量（Ｐ＜０．０１）。ＡＭＩ组ＲＣＤ最小余量与５．７５ｓ－１切变率的粘度呈正相关（ｒ＝０．３５０，Ｐ＜０．０５），与２３０ｓ－１切变率的粘度呈明显正相关（ｒ＝０．５６２，Ｐ＜０．００１）。结论：直接检测ＲＣＤ的变化，对估测活动期心脑血管病及糖尿病微血管病变的轻重及治疗效果有一定的意义。

Objective:To inevstigate the significance of erythrocyte deformability on acute myocardial infarction,acute cerebral infarction and diabetes mellitus.Methods:Erythrocyte deformability,blood viscosity were measured with FM 4 erythrocyte filtration instrument in diabetes mellitus,acute myocardial infarction,acute cerebral infarction and normal control subjects.Results:It was found that the oblique rates in control group were higher than that of other groups.Significant reduction of erythrocyte deformability was found in the diabetes mellitus,acute myocardial infarction and acute cerebral infarction groups compared with normal control group( P <0 01, P <0 01, P <0 01,respectively).The oblique rates in control group were higher than that of other groups.There was a positive correlation between the erythrocyte deformability and high or low shear rate blood viscosity in patients with acute myocardial infarction ( r =0 562, P <0 001; r =0 350, P <0 05).Conclusions:These data indicate that changes of erythrocyte deformability may play an important role in the pathogenesis of ischemia vascular cardialcerebral diseases.