IgA肾病患者血液流变学与血瘀证关系的探讨

Relationship between Hemorheology and Blood Stasis Syndrome in Patients with IgA Nephropathy

[目的]观察IgA肾病血液流变学指标及其与血瘀证的关系。[方法]根据血瘀证评分标准将184例IgA肾病患者分为血瘀证组168例（轻度组105例、重度组63例）和非血瘀证组16例，分别进行血液流变学检测，观察各项指标与血瘀证的关系。[结果]血液流变学各项指标中红细胞变形指数与血瘀证积分负相关（r=-0．9355），其余指标与血瘀证积分正相关（r=0．1452～0．9722），相关性显著（P〈0．01或P〈0．05）。血瘀证组（轻度组、重度组）与非血瘀证组的血液流变学各项指标比较，均有显著性差异（P〈0．01或P〈0．05）；重度血瘀证组与轻度血瘀证组的血液流变学各项指标比较，均有显著性差异（P〈0．01或P〈0．05）。肾功能正常组与肾功能异常组的血液流变学各项指标比较，除血浆粘度、纤维蛋白原外，均有显著性差异（P〈0．01或P〈0．05）；肾功能异常组的血瘀证积分显著高于肾功能正常组（P〈0．01）。[结论]IgA肾病患者处于血液高凝高粘、血液流变性异常、微循环障碍状态，其血液流变学各项指标与血瘀程度密切相关，血液流变性异常和血瘀是其病情进展的重要因素。

[Objective] To observe the relationship between hemorheology and blood stasis syndrome in patients with IgA nephropathy. [Methods]184 patients with IgA nephropathy were divided into three groups according to the scoring criteria of blood stasis syndrome： two bkxxt stasis syndrome （BSS） groups （168 cases, including 105 cases of the serious BSS subgroup and 63 cases of the mild BSS subgroup）and a non-blood stasis syndrome （non-BSS） group （16 eases）. Hemonheology was measured and the relationship between the hemonheology indexes and BSS was observed. [Results]There was a negative oorrelation between the deformation index of Red Blood Cell（ RBC） and BSS scores （ r = - 0. 9355 ）. The remaining indexes were positively oorrelated with the BSS scores （r = 0. 1452～0. 9722）; the oorrelation was significant （P 〈 0.01 or P 〈 0.05）. Comparing the hemorheology indexes among two BSS subgroups and the non-BSS group, there were prominent differences（ P 〈 0.01 or P 〈 0.05） ;between two BSS subgroups, a significant difference was observed （P 〈 0.01 or P 〈 0.05）; between the normal-renal-function group and the abnormal-renal-function group, there were significant differences in all the indexes except plasma viscosity and fibrinogen（ P 〈 0.01 or P 〈 0.05）. The bloot stasis scores of the abnormal renal [unetion group were distinctly higher than those of the normal renal function group（ P 〈 0.01）. [Conclusions]Hemorheology indexes are closely associated with the degree of blood stasis when hypereoagulability and hyperviscosity of blood, abnormal hemorheology and microcirculation disturbance are observed in patients with IgA nephropathy. Abnormalities of hemorheolcgy and blood stasis are important factors in the progression of IgA nephropathy.