6%羟乙基淀粉(130/0.4)对急性心肌梗死合并休克患者血液流变学的影响

Effect of 6% hydroxyethylstarch(130 / 0.4) on hemorheology in patients with acute myocardial infarction complicated by shock

目的:观察6%羟乙基淀粉(130/0.4)对急性心肌梗死(AMI)合并休克患者早期液体复苏前后血液流变学的影响。方法:将72例AMI合并休克患者随机分成两组,即Ⅰ组用6%羟乙基淀粉(130/0.4)早期液体复苏;Ⅱ组用平衡盐(1.86%乳酸钠溶液和复方氯化钠溶液之比为1∶2)液体早期复苏,另设36例正常对照组为Ⅲ组。于入科后和液体复苏后2～3 h测定Ⅰ组、Ⅱ组血液流变学指标。结果:Ⅰ组液体复苏后与Ⅱ组液体复苏后相比,全血(高切、低切)黏度、红细胞聚集指数、红细胞压积、纤维蛋白原、血小板聚集率明显降低,差异有统计学意义(P<0.05或P<0.01)。结论:6%羟乙基淀粉(130/0.4)能有效改善AMI合并休克患者血液流变学异常。

Objective To observe the effect of 6% hydroxyethylstarch （130/0.4） on hemorheology inpatients with acute myocardial infarction （AMI） complicated by shock before and after early fluid resuscitation. Methods 72 AMI patients complicated by shock were randomly divided into two groups, namely group with 6% hydroxyethylstarch （130/0.4） for early liquid resuscitation and group Ⅱ with balanced salt （1.86% sodium lactate solution and compound sodium chloride solution for a ratio of 1：2） for liquid recovery; and another 36 subjects was assigned to normal control group （group Ⅲ ）. The hemorheological indices were detected after admission and 2 to 3 hours after fluid resuscitation in groups Ⅰ and Ⅱ. Results After fluid resuscitation, high- and low-shear viscosity, red cell aggregation index, hematocrit, fibrinogen, and platelet aggregation rate decreased in group Ⅰ and group Ⅱ , with significant statistical differences （P 〈 0.05 and P 〈 0.01 ）. Conclusions 6% hydroxyethylstarch （130/0.4） can effectively improve abnormal hemorheology in patients with AMI complicated by shock.