血栓通联合等容血液稀释治疗视网膜静脉阻塞对纤溶活性及血液流变学的影响

目的探讨血栓通（ｐａｎａｘｎｏｔｏｇｉｎｓａｎｇｓａｐｏｎｉｎｓ，ＰＮＳ）、等容血液稀释（ｉｓｏｖａｌａｅｍｉｃｈａｅｍｏｄｉｌｕｔｉｏｎ，ＩＨＤ）以及二者联合治疗视网膜静脉阻塞（ｒｅｔｉｎａｌｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＲＶＯ）的效果。方法采用ＰＮＳ、ＩＨＤ及二者联合随机对照治疗ＲＶＯ患者７３例，观察治疗前后患者血浆组织型纤溶酶原激活物（ｔｉｓｓｕｅｐｌａｓｍｉｎｏｇｅｎａｃｔｉｖａｔｏｒ，ｔ－ＰＡ）及其抑制物（ｐｌａｓｍｉｎｏｇｅｎａｃｔｉｖａｔｏｒｉｎｈｉｂｉｔｏｒ，ＰＡＩ）活性、血液流变学参数及视力的改变。结果治疗结束时，ＰＮＳ＋ＩＨＤ组和ＰＮＳ组较治前ｔ－ＰＡ活性增高；ＰＡＩ活性降低；ＩＨＤ组ｔ－ＰＡ活性和ＰＡＩ活性改变不明显；除ＩＨＤ组血浆粘度变化不明显外，三组患者血液流变学指标均有不同程度改善。治疗后１个月，ＰＮＳ＋ＩＨＤ组全血低切粘度、低切还原粘度和红细胞聚集指数及其聚集力较治疗前仍有显著差异；且视力改善亦较快、较好。结论ＰＮＳ联合ＩＨＤ治疗ＲＶＯ具有调节机体纤溶功能和较持久地降低血液粘度，提高治疗效果的作用。

The effect of combined treatment of xue shuan tong and isovalaemic haemodilution on activities of fibrinolysis and hemorrheology in patients with retinal vein occlusion

Objective To explore the effect of xue shuan tong(panax notoginsang saponins,PNS)or isovalaemic haemodilution(IHD)and PNS combining IHD treatment on activities of fibrinolysis and hemorrheology in patients with retinal vein occlusion (RVO). Methods Seventy three patients with RVO were allocated at random to 3 groups which were treated with PNS,IHD and PNS combining IHD.The activities of t PA and PAI,rheological parameters and visual acuity before and after treatment were observed. Results At the end of treatment,significantly increased activity of t PA and decrease of PAI was found in combined treatment group and PNS group,but the difference before and after treatment was not significant in IHD group.Furthermore,except the plasma viscosity in IHD group,the other hemorrheological parameters in all the petients of 3 groups revealed to be improving.One month after treatment,the parameters return completely to normal in both PNS and IHD groups;while the whole blood apparent relative viscosity in low shear rate,RBC aggregation and RBC deformability maintained still in lower level,and also the visual acuity resumed better and quicker in combined group. Conclusion Combined treatment of PNS and IHD can both regulate the activity of fibrinolysis and decrease the blood viscosity of patients with RVO for a period of relatively long time and increase the effect of treatment.