犬急性心肌缺血时继发性血液流变学改变的实验研究

Experlmeritlal studies of changes of Hemorrheology in dogs with acute myocardial ischemia

本文对20条犬进行急性心肌缺血实验,以缺血前标本作自身对照,研究急性心肌缺血对血液流变学影响。结果表明:急性冠脉缺血后1小时,低切变率(1.92S^(-1),3.84S^(-1))全血粘度较缺血前显著升高(38.61±6.31对33.74±6.97,P<0.001;27.85±5.24对22.95±4.99,P<0.01),伴存红细胞压积增加,变形能力降低,聚集指数增加和血浆粘度升高等粘滞因子异常。同时,血液凝固性升高,表现为血小板聚集性增强和血栓素、血栓素/6酮前列环素增加。此外,也发现微血管内皮肿胀、毛细血管堵塞、管周外渗和纤维连接蛋白减少等改变。我们认为急性心肌缺血时存在的继发性血液高粘、高凝状态及其相关因子,是妨碍组织灌流和加重缺血损害的原因之一,此为临床解释病情、改进治疗具有指导意义。

This paper presents to study the changes of hemorrheology in dogs with acute myocardial ischemia. The results demonstrated that the whole blood viscosity (at low shear rate of 1. 92S-1,3. 84S-1)rose clearly(38. 61±6. 31 VS 33. 74±6.97,P&lt;0. 001,27. 85±5. 24 VS 22. 95±4.99,P&lt;0.01)and plasma viscosity were increased significantly following 1 hour of coronary ischemia. At the same time ,the increased aggregation of platelets and the thrombox B2 and the ratio of thrombox B2/6-Keto PGF1,was noted. In addition, it was found that the swelling endothelial cell and the plugged luminal of capillaries were decreased. It was suggested that there were high-viscosity、 hypercoagulable secondly and their relative fact during acute coronary ischemia、which could result in microcirculatory disturbance and extend ischemical myocardial damage.