无症状性心肌缺血与微循环—血液流变学

Silent Myocardial Ischmia (SMI) and Microculation-Hemorheology

目的 通过67例无症状性心肌缺血(SMI)的血液流变学及微循环变化,探索SMI发病的病理生理,以及SMI治疗及预防的原则。方法 将经过24h Holter监测而诊断为SMI的患者,进行血液流变学及甲襞微循环检测,并将结果与同期收治的不稳定型心绞痛(UAP)46例作对比。结果 SMI的血流变呈高粘、高聚、高凝状态,微血管管径变窄,流速变慢,各项指标均明显高于正常人(P<0.01)。而与UAP对比,差异无明显性(P>0.05)。结论 血液的高粘滞状态,导致微循环障碍,是SMI发生的主要病理生理。改善血液粘滞性,活跃微循环,将提高SMI的治疗效果。定期监测,并及早处理血液粘稠性,有助于预防SMI的发生。

Objective According to the Hemorheology for Silent Myocardial Ischemia and Microcirculation changing, studing the pathology and physiology of the disease of SMI, and also the principle of the treatment and prevention for SMI. Methods The patients with 24 hours Holler examination diagnosed SMI were testing by hemonheology and nailfold microcirculation. The result compared with 46 Unstable anging Pectories (DAP) that recovered at the same period.Results Hemonheology of SMI showed high viscosity, high aggregation, high coagulation. The path of blood vessel was narrow, blood flow was slower, the top of capillary loops. All items of index compared with nomal person (P > 0.01) .But compared with UAP, the difference was not remarkable(P > 0.05) . Conclusion The high blood viscosity will cause microcirculation obstacle. It is the important pathology and physiology that causing the disease of SMI. To improving the blood viscosity and activing the microcirculation will raise the treatment effect for SMI. Testing and treating the blood viscosity early are helpful to prevent the SMI.