慢性肺心病血液流变学的临床研究

CLINICAL RESEARCH ON HEMODYNAMICS OF CHRONIC PULMONARY HEART DISEASE

本文旨在研究慢性肺心病时继发性RBC增多与血液流变学部分指标、血球压积(Nct)、沉(ESR)、血小板计数(PC)以及动脉血氧饱和度(SaO_2)与PC之关系及临床意义。慢性肺心病67例,系住院患者。每例测定PaO_2、SaO_2、RBC、Hb、Hct、ESR、PC。并分别以Hb、SaO_2为自变量。Hct、ESR、PC为因变量进行直线回归分析,求直相关系数,比较Hb与Hct、ESR、PC和SaO_2与PC之关系。结果表明,慢性肺心病患者随着Hb增多,Hct增高,ESR下降变慢,PC也有下降趋势。SaO_2与PC呈正相关,即SaO_2下降,PC下降。本文讨论了慢性肺心病RBC增多引起Hct、ESR、PC等变化的机理,并讨论了Hct、ESR和PC变化的临床意义。指出Hct>55％,ESR<5mm/h说明肺心病均伴有循环和呼吸衰竭。Hct60％,ESR<1～2mm/h多为危重病人。PC降低一定程度上也反映了慢性肺心病患者的缺氧程度。建议Hct、ESR和PC的检测应列为慢性肺心病的常规检查项目。

The hemodynamics of 67 patients with chronic pulmonary heart disease was examined. The relationship among some indexes tested was studied and their correlation coefficients were calculated. The results showed that hematocrit (Hot) increased and erythrocyte sedimentation (ESR ) became slower as Hb increased. Oxygen saturation of blood (SaO2) was positive correlative to platele vomit (PC). The mechanism of these changes and their clinical significance are discussed. It is suggested that Hot, ESR and PC should be includd in the routine laboratory test items for patients with chronic pulmonary heart disease.