人体位季节改变对血液流变学参数的影响

Effect on parameters of blood rheology with different postures and season

目的探索人不同体位、季节对血液流变学参数的影响,为循证医学提供实验证据。方法 200名志愿者经自身配对设计,在冬、春、夏3季,抽取坐、卧姿两种体位血液,检测血液流变学14项指标。用SPSS 13.0软件进行自身配对t检验,统计医院5年数据库7452例血液流变学检测资料,以大样本来验证体位的影响。结果体位改变对血液流变学14项检测参数差异有统计学意义(P<0.01),其中全血(低切、中切、高切)黏度、全血还原(低切、中切、高切)黏度、血浆黏度、红细胞压积、红细胞聚集指数、红细胞刚性指数等10项指标,从坐姿到卧姿,平均降低9.36%,而红细胞变形指数、红细胞电泳指数、血沉、血沉方程K值等4项则成负相关,平均升高10.19%,最高的升高18.25%;大样本统计显示变异程度与实验组接近。结论地心引力、季节可导致不同体位血液流变学的显著生理变异,临床在分析实验结果时,应考虑体位因素,可减少10%的误诊率。

Objective Effect of different body postures and season on parameters of blood rheology was studied for the laboratory evidences for evidence - based medicine （EBM）. Methods Blood samples were drew from 200 paired volunteers at the same site in the postures of sitting and lying respectively in spring, summer and winter. 14 parameters of blood theology of each sample were tested. Paired t - test was carried out with SPSS 13.0 software, various parameters of blood rheology of 7452 samples in recent 5 years proved the influence different postures by large - scale sample. Results Deference of 14 parameters of blood rheology in sitting and lying of postures had great significance （ P 〈 0. 01 ）. The parameters such as whole blood viscosity （high, midst and low sheers）, blood reduce viscosity （high, midst and low sheers）, plasma viscosity, hematocrit, index of erythrocyte aggregation, index of erythrocyte rigidly were decreased by 9.36% on average as posture changed from sitting to lying. But index of erythrocyte deformabilty, erytbrocyte electrophresis, erythrocyte sedimentation （ESR）, ESR- K, presented inverse correlation with posture by increasing 10. 19% on average. Variation degree in sitting and lying postures is near to the laboratory group. Conclusion There is significant difference in 14 parameters of blood rbenlogy from the postures of sitting to lying because of gravity. While analyzing the laboratory results, doctor should take body posture into consideration, which decreases the rate of misdiagnosis about 10 percent.