慢性肺源性心脏病患者血液粘弹特性变化

The Changes of Viscoelastic Properties of Whole Blood in Patients with Chronic Cor Pulmonale

本文报道了病情程度不同的61例肺心病患者的血液粘弹特性及高、低切变率、全血表观粘度等的变化,及其与动脉血氧分压和二氧化碳分压的关系、治疗前后的动态变化。结果表明:肺心病患者血粘弹特性及血粘度随病情加重其改变越显著;低氧血症及高碳酸血症对血粘弹特性有肯定影响;肺心病患者经抗感染等一般的治疗后,血粘度及血粘弹特性仅部分指标有一定程度改善。

The changes of blood vis-coelasticity and apparent viscosities at lowshear rate (0.512 s^(-1))and high shear rate(51.2 ^(-1)) were studied in 61 patients withvarious severity of chronic cor pulmonale(CCP). The relation between blood vis-coelasticity and apparent viscosities andPaO_2 and PaCO_2 was investigated and data were collected before and aftertreatment. Grouped data:Group 1. A total of, ?patients with CCP were studied, 10 ofthem died during hospitalization. Sixty-one patients at the acute stege were divi-ded into mild,severe and dead sub group.Twenty-nine patients were improved aftertreatment. Group 2. Control group (74normal people) matched group 1 in sexand age. The results demonstrated that η_(0.512),η_(51.2)anb η′were slightly increased inthe mild group, but HCT, η_(0.512), η_(51.2),AI, η′and η″ were elevated more signi-ficantly in the severe group. All variablesmentioned above of died patients wereelevated more remarkedly than that ofthe mild group. HCT, η″ in dead patients were slightly higher than those in severegroup (P<0.05-0.01). It was clear that the more severe the patient, the moreincreased the hemotocrit and RBC aggre-gation, the less the RBC deformability.HCT would be elevated when PaO_2was below 8 kPa (60 mmHg) and the HCT,η_(0.512),η′,increased significantly (P<.05-0.01) when PaCO_2 was over 6.65kPa(50 mmHg). There was a positive linearcorrelation between η_(0.512) and PaCO_2. Itcan be expressed with an equation:Y(PaCO_2)=33.3736+0.5706×(η_(0.512) (r=0.6133,P<0.001) η_(0.512),is an impor-tant parameter indicating the RBCaggregation;η_(0.512) and η′were decreasedstatistically after conventional therapy.This paper revealed that the abnormalincrease in HCT and RBC aggregationand/or a decrease of RBC deformabilitymay be one of the important factors inproducing and developing CCP.