冠心病患者治疗前后促红细胞生成素和血液流变学的动态变化及对血黏度的影响

Dynamic changes of erythropoietin and hemorheology in patients with CHD before and after treatment and effect on blood viscosity

目的观察促红细胞生成素(EPO)、血常规、血液流变学参数在冠心病患者PCI前后24 h的动态变化及对血黏度的影响。方法选择冠心病患者117例,分为急性心肌梗死组(心梗组)45例,不稳定性心绞痛组(不稳定组)50例,稳定性心绞痛组(稳定组)22例;另选取健康体检者40例为对照组。对患者入院、PCI后24 h的EPO、血常规和血液流变学进行对比分析,并进行Pearson相关分析。结果与治疗前比较,心梗组、不稳定组、稳定组患者治疗后FPO、红细胞聚集指数、红细胞压积明显下降,血红蛋白、血小板、全血黏度低切明显升高(P<0.05,P<0.01);Pearson相关分析显示,冠心病患者治疗前和治疗后EPO与红细胞聚集指数、红细胞压积呈正相关,与血红蛋白、全血黏度低切、血小板呈负相关(P<0.05,P<0.01)。结论内源性EPO可能通过红细胞聚集指数、红细胞压积、血红蛋白、血小板、全血黏度低切间接影响冠心病患者的血黏度,且治疗前和治疗后冠心病患者均处于高血黏度状态。

Objective To observe the dynamic changes of erythropoietin（EPO）,blood routine and hemorheology parameters in patients with coronary heart disease before and 24 hours after percu taneous coronary intervention（PCI） and effect on blood viscosity. Methods 117 patients with coronary heart disease were divided into 3 groups：acute myocardial infarction（MI）, unstable angina （UA） and stable angina（SA）,40 healthy subjects served as control group. EPO, blood routine and hemorheology were measured on admission and 24 hours after PCI. Comparative analysis and Pearson correlation analysis were done. Results After treatment,EPO,index of erythrocyte aggregation and hematocrit decreased, hemoglobin, platelet count and low-shearing whole blood vis cosity increased significantly in MI,UA and SA groups compared with before treatment. Pearson correlation analysis showed that EPO was correlated significantly positively with index of eryth rocyte aggregation and hematocrit （ P〈 0.05 ）, negatively with haemoglobin, platelet count, low-shearing whole blood viscosity before and 24 hours after intervention in patiens with coronary heart disease（P〈0.05）. Conclusions Endogenous EPO might influence blood viscosity through index of erythrocyte aggregation, hematoerit, haemoglobin, platelet,low-shearing whole blood vis- cosity indirectly,and patients with coronary heart disease were in status of high blood viscosity before and 24 hours after treatment.