藻酸双酯钠对脑血栓形成患者血液触变特性的影响

Using Low shear 30 rheometer, we measured the thixotropic parameters of blood from 30 patients suffering from cerebral thrombosis. The result showed that the yield stress (tau 0), non-Newtonian contribution of viscosity (eta s-mu) and viscosity of plasma (eta p) were significantly higher than those in the control group. Those patients were randomly divided into two groups. Each group included 15 patients. The patients in group 1 and group 2 were treated with poly-saccharide sulphate (PSS) and DX40 respectively by intravenous drip for 14 days. The results showed that tau 0, A, (eta s-mu) were significant decreased in group 1 after treatment, but no significantly change in the thixotropic parameters was found in group 2 after treatment. The total curative rate in group 1 was higher than that in group 2. These results suggest that the patients with cerebral thrombosis had evidently increased degree of RBC aggregation. PSS could decrease the aggregation of RBC more significantly than DX40 did. It was probably one of the reasons why the therapeutic effect of PSS on cerebral thrombosis was better than that of DX40.     

先天性心脏病患儿的全血触变特性

The thixotropic parameters of whole blood in two groups of children with congenital heart disease (CHD) were measured. Group 1. cyanotic heart disease (CCHD), 20 cases; Group 2. acyanotic heart disease (ACHD), 30 cases. Fifty healthy children were controls matched with the patients in sex and age. Their thixotropic parameters were compared; the paired t-test was used. In the children with CCHD, the hematocrit (HCT), the yield stress (tau 0) the Newtonian contribution of viscosity (mu), the equilibrium value of the structural parameter (A), the apparent viscosity at 2.37 sec-1 (eta s) and the Non-Newtonian contribution of viscosity (eta s-mu) were significantly higher than those in corresponding control groups. In the children with ACHD, only the values of tau 0, eta s-mu, and eta s were higher than those in control groups. All of the thixotropic parameters in CCHD group were significantly higher than those in ACHD group. Thus we described quantitatively CHD in terms of thixotropy of blood. The thixotropic parameters of blood could be used as indexes of severity for pathologic changes of CHD.     

中国成年人全血触变特性的研究

This study measured the thixotropic parameters of whole blood from 314 healthy subjects (154 women, 160 men) with our modified method by Low Shear-30 Rheometer according to Huang's equation. We suggested the range of normal values of thixotropic parameters from man and woman group. The results demonstrated that no significant differences existed in the plasma viscosity (eta p) and fibrinogen between man and woman group. Man group had significantly higher values than those in woman group in hematocrit (HCT), yield stress (tau 0), Newtonian contribution of viscosity (mu), non-Newtonion contribution of viscosity (eta s-mu), apparent viscosity at 2.37s-1 (eta s), the equilibrium value of the structural parameter (A) and apparent kinetic rate constant of rouleaux breakdown (ARC). The man and woman groups could be separately divided into five subgroups on the basis of age. All parameters were compared with one another and treated statistically. We found that the levels of fibrinogen and eta p had an increasing trend with aging. In the old subgroup (greater than or equal to 60 years) of man and woman, HCT, tau 0, mu, eta s, (eta s-mu) and A had significantly lower values than those in young and middle age subgroups. However, it was very interesting that there were differences of ARC versus age between the man and woman groups, i.e., ARC in the man subgroup 3, 4 had lower values and in the woman subgroup 2, 3, 4 had higher values than their respective older subgroups did.     

脑血管患者血脂变化及调脂治疗对其预后的影响

目的通过分析脑血管病患者血脂变化规律和比较其调脂治疗疗效,探讨血脂对脑血管病发生、发展及预后的影响。方法收集脑梗死组108例、脑出血组84例及对照组92例（未发生脑卒中患者）,用比色法测其甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDLC）及低密度脂蛋白胆固醇（LDLC）水平。采用随机分组将脑出血及脑梗塞患者随机分为调脂治疗组及非调脂治疗组,并进行脑卒中临床神经功能缺损评分（FAM）（近期疗效）及3个月后日常生活能力（ADL）分级评定（远期疗效）。结果脑血管病患者（脑出血、脑梗塞）的TG、TC、LDLC水平明显高于对照组,而HDLC低于对照组;脑出血组TC、LDLC低于脑梗塞组;调脂治疗组1个月后FAM评分低于非调脂治疗组,而3个月后ADL分级评定好于非调脂治疗组。结论高TG、TC、LDLC及低HDLC水平是脑血管病的危险因素;低TC、LDLC更易发生脑出血;调脂治疗能改善脑血管病患者的预后。     

动力型微泡清除器在体外循环冠状动脉旁路移植术中的初步应用

目的　明确动力型微泡清除器 (DBT)在冠脉搭桥患者体外循环 (CPB)全过程中减少动脉灌注管道和大脑中动脉内微气泡的效果及其对血细胞和凝血机能的影响。方法　 2 0例患者随机分组 ,DBT组在动脉滤器与主动脉插管之间接入DBT。检测DBT前、后的动脉灌注管内和对照组相应位置的微气泡量和患者双侧大脑中动脉内微栓信号 (MES)量。术前、CPB停止和术后 6h分别测定血浆游离血红蛋白 (PFH)、乳酸脱氢酶 (LDH)、血小板计数、纤维蛋白原、凝血因子Ⅱ活性、抗凝血酶Ⅲ(ATⅢ )活性。结果　DBT组动脉灌注管内不同直径微气栓的清除率分别为 6 8%～ 74 % (10～ 12 0 μm) ,79%～ 81% (2 0～ 12 0 μm)和 88%～ 96 % (40～ 12 0 μm )。整个CPB期间大脑中动脉内MES总值 ,DBT组 (178± 12 2 )比对照组 (197± 137)有减少的趋势 ,但差异无显著意义。血细胞破坏和凝血机能各指标在两组间差异无显著意义。结论　DBT能高效清除体外循环动脉灌注管内微气泡并且不加重血细胞的破坏或凝血抗凝机制的紊乱。要最大程度消除入脑气体微栓须采取综合临床措施 ,而DBT是有效手段之一。     

年轻脑梗死患者脂蛋白(a)和颈动脉粥样硬化相关性研究

目的探讨年轻脑梗死患者脂蛋白(a)和颈动脉粥样硬化的相关性.方法回顾性分析近3 a连续住院的年轻脑梗死患者,年龄18～50岁,同时把患者颈动脉粥样硬化程度进行分级:(Ⅰ级)无动脉粥样硬化;(Ⅱ级)动脉粥样硬化而无血管狭窄;(Ⅲ级)血管狭窄≥50%.多因素逻辑性回归分析血浆蛋白(a)与颈动脉粥样硬化的相关性.结果共132例患者男/女:79/53;平均年龄(42.2±6.5)岁;78例为Ⅰ组,42例为Ⅱ组,12例为Ⅲ组.多因素逻辑性回归分析显示血浆脂蛋白(a)浓度与颈动脉粥样硬化分级有明显相关性(P<0.01).结论年轻脑梗死患者血浆脂蛋白(a)[Lp(a)]浓度与颈动脉粥样硬化程度有明显相关性.这种相关性同其他已知脑梗死危险因素一样,是脑梗死独立的危险因素,如吸烟、胆固醇升高.     

自体静脉移植与胰岛素样生长因子-Ⅰ重建勃起反射通路的实验研究

目的 探讨自体静脉移植结合使用胰岛素样生长因子-Ⅰ(IGF-Ⅰ)重建勃起反射通路的可行性。方法 将48只雄性成年SD大鼠随机分成4组,每组12只。Ⅰ组:假手术组,只找到双侧海绵体神经(CN)即关闭切口;Ⅱ组:CN离断组,切除大鼠双侧CN约5 mm及其侧支;Ⅲ组:静脉移植 IGF-Ⅰ组,在Ⅱ组的基础上,用大鼠自体静脉移植桥接缺省的CN,并向移植静脉管腔内注射IGF-Ⅰ;Ⅳ组:静脉移植 生理盐水组,用等量的生理盐水代替Ⅲ组的IGF-Ⅰ。4个月后,阿朴吗啡试验评估大鼠的勃起功能;然后在大鼠阴茎海绵体内注射荧光金,对CN逆行追踪。结果 Ⅲ组的勃起率达92％(11/12),明显高于Ⅱ组(50％)和Ⅳ组(O％),P<0.01。荧光显微镜下计数,Ⅲ组盆神经节中荧光金阳性着色细胞数明显多于生理盐水组和CN切断组(P<0.01)。结论 自体静脉移植结合使用IGF-Ⅰ,是一种有效的治疗因CN损伤而致勃起功能障碍的新方法。     

脑血管顺应性与血液理化特性的关系

目的：观察血液的理化特性与脑血管顺应性的关系。方法：选定大脑中动脉（MCA）梗死区的患者,利用经颅多普勒（TCD）超声仪测定MCA的收缩期峰速度（Vs）、舒张末期速度（Vd)及平均速度（Vm）。然后求出脉动指数（PI）：PI＝（Vs-Vd)/Vm。据PI是否大于1分为两组,观察两组间的血流变、血脂及纤维蛋白原的改变。结果：两组间TC、TG、apoB、HDL、LDL及纤维蛋白原（Fig）等皆有显著性差异（P＜0．05）。结论：血液理化特性对血管顺应性有明显影响。     

Fluidity of erythrocyte membranes in patients with ischemic cerebral vascular disease

Measurement of fluidity of erythrocyte membrane (FEM) in thirty-six patients with ischemic cerebral vascular disease (ICVD) by fluorescence polarization of DPH (1,6,-Diphenyl-1,3,5-hexatriene) labelled on lipo-region in intact erythrocyte membrane. Twenty one healthy subjects without any stagnation of blood as control. Also research on coefficient of multiple correlation among the FEM and other factors in whole blood or plasma by using stepwise multi-regression analysis. The results revealed that: (1) FEM of patients with ICVD was 3.55 +/- 0.21 (eta), which was significantly higher than that of healthy subjects (2.77 +/- 0.12 eta), P less than 0.001. (2) The FEM of patients with ICVD were positive correlation with RBC electrophoresis rate, whole blood viscosity and low density lipo-proteins and were negative correlation with high density lipo-proteins. These findings suggested that it would be available for preventing ICVD by increasing of the surface charge on erythrocyte and of the high density lipo-proteins.     

中老年男性血糖与血清脂质及载脂蛋白的关系

OBJECTIVE: To gain an insight into the relation of plasma glucose levels to lipids and apolipoproteins levels. METHODS: Fasting 12-14 h blood glucose (BG), high density lipoprotein cholestrol(LDL-C), apolipoproteins(apo) A I, A II, B100, C II, C III and E levels were measured in 735 men aged 40-70 in Chengdu area. The subjects studied were divided into three groups by the plasma glucose levels: 1. normal group (S1), 2. decreased glucose tolerance group (S2), 3. diabetes mellitus (DM) group (S3). RESULTS: Among 735 cases studied, groups S2 and S3 had more hyperlipidemia than group S1 (64%, 45% and 32.2% respectively). The fasting serum mean TG levels in groups S2 (3.62 +/- 2.52 mmol/L) and S3 (4.45 +/- 3.82 mmol/L) group were significantly higher than that in group S1 (1.92 +/- 1.39 mmol/L) (P < 0.01 and P < 0.01), and the mean TG levels in groups S2 (5.68 +/- 1.15 mmol/L) and S3 (5.68 +/- 1.12 mmol/L) were higher than that in group S1 (5.13 +/- 1.06 mmol/L) (P < 0.05, P < 0.05). The serum apo B100, C II, C III and E levels in groups S2 and S3 were significantly higher as compared with that in the normal group (P < 0.01, P < 0.05). The correlation analysis indicated that there was a positive correlation of BG with serum TG in groups S1, S2 and S3 whose correlation coefficients (r) were 0.1800, 0.1436 and 0.3212 respectively (P < 0.001); and a negative correlation with HDL-C levels in groups S2 and S3 (r = -0.2534 and -0.1477, P < 0.001). The plasma glucose levels were positively correlated with apo B100, C III and E levels in groups S1, S2 and S3, P < 0.001), with apo C II in groups S1 and S2 (P < 0.001, P < 0.01); and negatively correlate to apoA I only in group S2 (r = -0.1182, P < 0.01). CONCLUSION: The results suggest that serum TG, TC, HDL-C, apoB100, C II, C III and E levels be the main factors that related to plasma glucose levels.