矽肺患者的血液流变状况及其临床意义

Hemorrheological Status in Patients with Silicosis and Its Clinical Significance

目的 探讨矽肺与血液流变学的关系及其临床意义。方法 检测了８５ 例男性矽肺患者、４５ 例男性慢性支气管炎患者及１００ 例健康男性对照者的血液流变学各项指标值。结果 与对照组和慢性支气管炎组比较，矽肺组的红细胞压积、切变率为４ ｓ－１ ～２００ ｓ－１ 时的全血表观黏度、血浆黏度、红细胞电泳时间、血小板电泳时间平均值均显著升高；不同病情矽肺组、不同肺功能状况矽肺组上述检测值的平均值均随病情加重、肺功能下降而升高，并均显著高于对照组。逐步回归发现，矽肺患者病情与红细胞压积、４ ｓ－１和２００ ｓ－１ 切变率时的全血表观黏度、红细胞电泳时间和血小板电泳时间相关最密切，而肺功能状况和病程却均与红细胞压积、４ ｓ－１ 和２００ ｓ－１切变率时的全血表观黏度、血浆黏度、红细胞电泳时间和血小板电泳时间相关最密切。结论 矽肺患者的血液呈高黏滞状况，极易并发多种疾病。

Objective To study relationship between silicosis and hemorrheology and its clinical significance. Methods Varied indices for hemorrheology were measured in 85 male patients with silicosis, 45 male patients with chronic bronchitis and 100 healthy male subjects. Results Compared with the control group and the chronic bronchitis patient group, average hematocrit (Hct), whole blood apparent viscosity (η a) at 4 s -1 ～200 s -1 shear rates, plasma viscosity (η p), erythrocyte electrophoresis time (EET) and platelet electrophoresis time (PET) all significantly increased in patients with silicosis ( P <0.001). Hemorrheological indices in patients with silicosis increased with severity of disease, increased with decrease in their pulmonary function, and were all significantly higher than those in the control group ( P <0.01～0.001). Stepwise regression analysis showed that severity of disease correlated closely to Hct, η a at 4 s -1 ～200 s -1 , EET and PET, and that pulmonary function status in patients with silicosis and their courses correlated closely to Hct, η a at 4 s -1 ～200 s -1 , η p, EET and PET. Conclusions Blood of patients with silicosis was in highly viscose status, which was easy to be complicated with multiple diseases.