目的了解低血红蛋白血症对冠状动脉病变的影响。方法选择接受冠状动脉造影（ coro-nary angiography ，CAG）检查且资料完整的患者共1024例，根据患者入院血红蛋白检查结果分为正常组（无贫血组）和低血红蛋白血症组（贫血组），其中贫...目的了解低血红蛋白血症对冠状动脉病变的影响。方法选择接受冠状动脉造影（ coro-nary angiography ，CAG）检查且资料完整的患者共1024例，根据患者入院血红蛋白检查结果分为正常组（无贫血组）和低血红蛋白血症组（贫血组），其中贫血组228例，无贫血组796例。比较2组患者的临床特点以及冠状动脉病变严重程度。结果贫血组患者除具有年龄较大，女性、糖尿病、脑血管病史、慢性肾功能不全病史、急性冠脉综合征比例较高的特点外，2支病变（41．2％比35．9％， P ＜0．01）、3支病变（36．4％比25．6％， P ＜0．01）、左主干病变（5．3％比2．6％， P ＝0．004）以及LAD近端病变（56．6％比48．6％， P＝0．017）所占比例显著高于无贫血组。多因素分析，校正其他因素后，低血红蛋白血症是冠状动脉病变严重程度的独立预测因素（RR1．46，95％CI 1．02～1．89， P ＝0．01）。结论低血红蛋白血症是冠状动脉病变严重程度的独立预测因素。展开更多
OBJECTIVE: To study the effects of low-molecular weight heparin (LMWH) and adrenocortical hormone (dexamethasone) on the hemolysis of red cells of patients with paroxysmal nocturnal hemoglobinuria (PNH) in vitro. METH...OBJECTIVE: To study the effects of low-molecular weight heparin (LMWH) and adrenocortical hormone (dexamethasone) on the hemolysis of red cells of patients with paroxysmal nocturnal hemoglobinuria (PNH) in vitro. METHODS: Using Ham's test and micro-complement lysis sensitive test (mCLST), the changes in hemolysis of red cells from 6 typical PNH cases were examined after adding LMWH and dexamethasone in different concentrations into the test solution in vitro. The effects of LMWH and dexamethasone on the coagulation of the tested blood samples were also studied using the activated partial thromboplastin time (APTT) test. RESULTS: Both LMWH and dexamethasone inhibited the hemolysis of PNH red cells, and they also showed a synergistic effect. The inhibiting effects were dose-dependent. Moreover, a tolerable dose of LMWH induced a limited prolongation of APTT. Dexamethasone showed two possible mechanisms in the inhibition of PNH red cells hemolysis through Ham's test and mCLST, respectively: (1) inhibiting both antibodies binding to red cells and (2) the initiation of the activation of complement 3 (C3). LMWH could inhibit hemolysis as determined by both Ham's test and mCLST, which indicated that LMWH could block the activation of complement cascade. CONCLUSIONS: Both LMWH and dexamethasone could inhibit hemolysis in PNH, and they showed a synergistic effect. Their mechanisms of inhibiting hemolysis differed from each other. Furthermore, a tolerable dose of LMWH induced a limited prolongation of APTT. LMWH might be useful for controlling acute hemolysis in patients with PNH and reducing the dose of adrenocortical hormone.展开更多
文摘目的了解低血红蛋白血症对冠状动脉病变的影响。方法选择接受冠状动脉造影（ coro-nary angiography ，CAG）检查且资料完整的患者共1024例，根据患者入院血红蛋白检查结果分为正常组（无贫血组）和低血红蛋白血症组（贫血组），其中贫血组228例，无贫血组796例。比较2组患者的临床特点以及冠状动脉病变严重程度。结果贫血组患者除具有年龄较大，女性、糖尿病、脑血管病史、慢性肾功能不全病史、急性冠脉综合征比例较高的特点外，2支病变（41．2％比35．9％， P ＜0．01）、3支病变（36．4％比25．6％， P ＜0．01）、左主干病变（5．3％比2．6％， P ＝0．004）以及LAD近端病变（56．6％比48．6％， P＝0．017）所占比例显著高于无贫血组。多因素分析，校正其他因素后，低血红蛋白血症是冠状动脉病变严重程度的独立预测因素（RR1．46，95％CI 1．02～1．89， P ＝0．01）。结论低血红蛋白血症是冠状动脉病变严重程度的独立预测因素。
文摘OBJECTIVE: To study the effects of low-molecular weight heparin (LMWH) and adrenocortical hormone (dexamethasone) on the hemolysis of red cells of patients with paroxysmal nocturnal hemoglobinuria (PNH) in vitro. METHODS: Using Ham's test and micro-complement lysis sensitive test (mCLST), the changes in hemolysis of red cells from 6 typical PNH cases were examined after adding LMWH and dexamethasone in different concentrations into the test solution in vitro. The effects of LMWH and dexamethasone on the coagulation of the tested blood samples were also studied using the activated partial thromboplastin time (APTT) test. RESULTS: Both LMWH and dexamethasone inhibited the hemolysis of PNH red cells, and they also showed a synergistic effect. The inhibiting effects were dose-dependent. Moreover, a tolerable dose of LMWH induced a limited prolongation of APTT. Dexamethasone showed two possible mechanisms in the inhibition of PNH red cells hemolysis through Ham's test and mCLST, respectively: (1) inhibiting both antibodies binding to red cells and (2) the initiation of the activation of complement 3 (C3). LMWH could inhibit hemolysis as determined by both Ham's test and mCLST, which indicated that LMWH could block the activation of complement cascade. CONCLUSIONS: Both LMWH and dexamethasone could inhibit hemolysis in PNH, and they showed a synergistic effect. Their mechanisms of inhibiting hemolysis differed from each other. Furthermore, a tolerable dose of LMWH induced a limited prolongation of APTT. LMWH might be useful for controlling acute hemolysis in patients with PNH and reducing the dose of adrenocortical hormone.
