原发性青光眼患者的血液流变学测定及意义

Determination of blood rheology indices in primary glaucoma patients

目的:研究原发性青光眼患者的血液流变学指标变化及意义。方法:测定18例开角型青光眼、20例急性闭角型青光眼、16例慢性闭角型青光眼和20例正常对照组的全血比粘度、血浆比粘度、红细胞比积、纤维蛋白原并进行比较。结果:开角型青光眼的全血比粘度、血浆比粘度、红细胞比积、纤维蛋白原均较正常对照组显著升高(P<0.01);急性和慢性闭角型青光眼的全血比粘度、血浆比粘度均较正常对照组显著升高(P<0.05～P<0.01),而红细胞比积、纤维蛋白原与对照组间差异无统计学意义(P>0.05);开角型青光眼的全血比粘度、血浆比粘度、红细胞比积,纤维蛋白原均较闭角型青光眼显著升高(P<0.01～P<0.05);急性闭角型与慢性闭角型青光眼的全血比粘度、血浆比粘度、红细胞比积、纤维蛋白原间差异均无统计学意义(P>0.05)。结论:原发性开角型青光眼与闭角型青光眼患者均具有高粘滞血症,是原发性青光眼视神经损害的潜在性危险因素;高血粘度在青光眼的发病机制上对开角型青光眼较对闭角型青光眼起着更为直接、重要的作用;高血粘度在急性闭角型与慢性闭角型青光眼的发病机制中均起着导致眼内微循环障碍、睫状体部位淤血、水肿,加速前房角关闭的作用。

Objective:To study the role of the blood rheology indices in the pathogenesis of primary glaucoma .Methods:The blood rheology indices were detected in18cases of primary open-an-gle glaucoma(POAG)patients,20cases of acute angle-closure glaucoma(PAACG)patients,16cases of chronic angle-closure glaucoma (PCACG)patients,20cases of normal subjects were chosen as control group.Results:The blood rheology indices in POAG group were significantly higher than those in the control group (P<0.01).The blood viscosity and plasma viscosity in primary angle-closure glaucoma (PACG)group were significantly higher than those in the control group (P<0.05～P<0.01).There was no significant difference for the hematocrit and fibrinogen between PACG and the control group(P>0.05).The blood rheology indices in POAG group were significantly higher than those of PACG group(P<0.05～P<0.01).There was no difference for the blood rheology indices between PAACG and PCACG group.Conclusions:The results suggest that both POAG and PACG patients have blood hyperviscosity which is a potential risk factor of glaucoma.The blood hyperviscosity plays a more important role in the pathegenesis of POAG than in PACG.The hyperviscosity may have similar effect in pathogenesis of PAACG and PCACG.