视网膜静脉阻塞及合并症患者血液流变性变化分析

目的:探讨视网膜静脉阻塞(RVO)及合并症患者血液流变学改变。方法:分别测定60例RVO患者血液流变学指标并分析合并高血压、糖尿病、高脂血症的RVO患者全血粘度、血浆粘度和红细胞压积等的变化。结果:RVO患者血流变指标较对照组明显升高(P<0.05或0.01);合并高血压和高脂血症RVO患者血粘度和红细胞压积明显异常。结论:血液流变性异常在RVO发病机制中可能起重要作用。     

Cation-osmotic haemolysis in stroke patients

Erythrocyte microrheology changes were measured by cation-osmotic haemolysis (COH) in healthy donors, patients with ischameic stroke, and patients who died within four days after a stroke. COH in patients with stroke was significantly decreased in comparison with that from healthy donors. In patients who died, COH was significantly decreased compared to patients who survived. The relationship between cationosmotic haemolysis and erythrocyte deformability is discussed.     

Cation-osmotic haemolysis in stroke patients

Erythrocyte microrheology changes were measured by cation-osmotic haemolysis (COH) in healthy donors, patients with ischameic stroke, and patients who died within four days after a stroke. COH in patients with stroke was significantly decreased in comparison with that from healthy donors. In patients who died, COH was significantly decreased compared to patients who survived. The relationship between cationosmotic haemolysis and erythrocyte deformability is discussed.     

羟苯磺酸钙对视网膜静脉阻塞患者血液流变性的影响

目的:观察羟苯磺酸钙对视网膜静脉阻塞(RVO)患者血液流变学相关指标的影响。方法:选择就诊于我院的RVO患者86例107眼,随机分为两组,对照组43例54眼,应用常规药物治疗,观察组43例53眼,在对照组基础上口服羟苯磺酸钙胶囊治疗,30天后,观察两组治疗前后的视力、眼底变化及血液流变学各项指标的改善情况。结果:观察组治疗总有效率(90.57%)明显优于对照组(71.93%),差异具有统计学意义(P<0.01)。与治疗前比较,两组视力、眼底病变及血液流变学相关指标(全血表观粘度、血浆粘度)均有不同程度的好转和改善,以观察组更为明显;治疗后,观察组患者血浆纤维蛋白原浓度、红细胞压积及红细胞聚集指数明显降低,红细胞电泳时间缩短,红细胞变形指数明显升高,与治疗前相比差异有统计学意义(P<0.05)。结论:羟苯磺酸钙能明显改善RVO患者血液流变性,具有较好的临床疗效。     

Baseline Predictors of Visual Acuity and Retinal Thickness in Patients with Retinal Vein Occlusion

This study investigated the baseline predictors of best corrected visual acuity (BCVA) and central retinal thickness (CRT) at 6 months in patients with treatment-naïve branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). This multicenter, interventional case series included 208 BRVO and 123 CRVO patients with follow-up period of 6 months or more. Outcome measures of BCVA (logMAR) included absolute change from baseline and a gain or loss of ≥ 0.3 from baseline. Outcome measures of CRT included absolute change from baseline and a measurement of ≤ 250 µm or ≥ 400 µm at 6 months. Univariate and multiple regression analyses were done to find baseline predictors. For BRVO, younger age, worse baseline BCVA, and shorter duration of symptom were associated with more gain in BCVA. For CRVO, worse baseline BCVA was associated with more gain in BCVA. For CRT outcomes, higher baseline CRT predicted greater decrease at 6 months in both BRVO and CRVO. Younger age and better baseline BCVA were associated with an increased likelihood of measurement of a ≤ 250 µm outcome for BRVO and CRVO, respectively. For CRVO, smoking was associated with greater decrease from baseline and decreased likelihood of measurement of a CRT ≥ 400 µm at 6 months. In conclusion, several baseline factors including age, symptom duration, and baseline BCVA and CRT are associated with BCVA and CRT outcomes at 6 months, which may help to predict disease course for RVO patients.

Graphical Abstract

相似文献   

Cerebral Blood Flow Velocity,Erythrocyte Deformability and Alcohol Intake

The aim of the study was to determine if there is a relationship between low blood flow velocity in the cerebral arteries and erythrocyte deformability in heavy alcohol drinkers. The study comprised 47 heavy alcohol drinkers (mean age 47 years). All of them drank daily more than 84 g of alcohol (84–400 g). Blood flow velocity (V _mean) in intracranial arteries was determined by transcranial Doppler. Erythrocyte membrane biophysical properties were estimated using the method of cation-osmotic haemolysis (COH). The present study revealed a significant decrease in V _mean in all examined arteries, with p= <0.01 in the middle (MCA) and posterior (PCA) cerebral arteries and p= <0.05 in the anterior cerebral artery (ACA) when compared with age-matched controls. Cation-osmotic haemolysis in the low ionic strength of the incubating medium (15.4 mmol/l NaCl) as well as in the high ionic strength (123.2–154.0 mmol/l NaCl) was significantly decreased (p<0.001–0.01). This means that changes in both parts of the erythrocyte membrane (actin–spectrin complex and membrane lipid bilayer) are the cause of decreased erythrocyte deformability. We conclude that one of the factors which can cause low blood flow velocity (a possible risk factor for stroke) is decreased cation-osmotic haemolysis of erythrocytes.     

川芎嗪治疗视网膜静脉阻塞的疗效与机理

目的 观察川芎嗪治疗视网膜静脉阻塞的疗效与机理。方法 视网膜静脉阻塞患者治疗组３５例，用川芎嗪治疗，对照组３０例用血栓通治疗。通过视力检查，荧光素眼底血管造影和眼底检测评价疗效。结果 经４疗程的治疗，治疗组总有效率为８２．９％，与血栓通组相似，但在视力恢复上优于血栓通组。结论 川芎嗪对治疗视网膜静脉阻塞有较好作用。     

Methaemoglobin Formation in Euros and Bettong

Oxidant sensitivity was investigated in erythrocytes from Barrow Island euro (Macropus robustus isabellinus), mainland euro (Macropus robustus erubescens) and brushtailed-bettong (Bettongia pericillata). Oxidant sensitivity was tested by measuring methaemoglobin formation in haemolysates treated with H₂O₂ or NaNO₂. Barrow Island euro produced the highest methaemoglobin formation with H₂O₂. There was a significant negative correlation between catalase activity and H₂O₂-induced methaemoglobin formation. Our results provide further evidence supporting previous findings on eight species of marsupials.     

Osmotic Fragility and Erythrocyte Size in Iguana iguana (Sauria – Iguanidae) in Captivity

The erythrocyte size and osmotic fragility were studied in blood samples from adult (n= 40) and juvenile (n= 40) specimens of Iguana iguana. In fresh preparations the erythrocytes were large, oval cells. The largest diameters were 17.06 ± 2.5 mm (juvenile) and 16.20 ± 1.25 mm (adults), and the smallest diameters were 8.23 ± 1.87 mm (juvenile) and 9.00 ± 1.00 mm (adults). In fixed and stained preparations, the largest erythrocyte diameters were 15.28 ± 3.3 mm (juvenile) and 15.51 ± 1.3 mm (adults), and the smallest were 7.82 ± 0.65 mm (juvenile) and 7.85 ± 0.8 mm (adults). The haematocrit value for both juvenile and adult specimens was 27 ± 2%; the red blood cell counts were 1.3 ± 0.43×10¹²/l (juvenile) and 1.2 ± 0.35×10¹²/l (adults). Although no significant differences were observed in the cumulative osmotic curves, the derivative curve of adult specimens indicates the presence of at least two erythrocyte populations with osmotic fragilities at about 70 and 60 mm NaCI, representing 27% and 73% of the total cells, respectively. In samples from juvenile specimens, a major peak at about 70 mm NaCI was observed, which represented 85% of the total cell population. The difference in osmotic resistance between these erythrocyte subpopulations is correlated with their respective geometrical parameters, and compared to that of erythrocytes from other vertebrates.     

Oxidant Defence in the Red Blood Cells of the Greyheaded Flying Fox, Pteropus poliocephalus

The red blood cells (RBC) of bats (Order Chiroptera) are morphologically similar to those of other mammals, but the suborder Megachiroptera are unique in responding to very high demands for oxygen supply, more than 30 times that of resting conditions. Although greater efficiency of these cells to transport oxygen is advantageous to the animal, it could potentially expose the RBC to higher than average risk of oxidant damage. The aim of the present study was to investigate the capacity of RBCs of Pteropus poliocephalus, the greyheaded flying fox, to defend itself against oxidant stress. RBC of flying fox and human were challenged with 2,2′-azobis(2-amidinopropane) dihydrochloride (AAPH). The RBC from the two species were found to have similar reduced glutathione (GSH) reduction kinetics and succumbed to haemolysis at similar rates. However, haemoglobin oxidation was much faster in the flying fox suggesting that the RBC of flying fox may not enjoy as good protection as those of humans in the event of an oxidant stress.     

The Effect of Potassium Concentration on Glycolysis in High and Low Potassium Dog Erythrocytes

The effect of potassium concentration on glycolysis was studied in the erythrocytes of Japanese Shiba dogs with high potassium (HK) and low potassium (LK) concentrations. When intracellular Na and K concentrations were changed in intact erythrocytes, lactate formation increased with increasing K concentration in both HK and LK dogs. In the reconstituted haemolysates, lactate formation, phosphofructokinase (PFK) and pyruvate kinase (PK) activities increased with increasing K concentration in both HK and LK dogs. These results suggest that glycolysis in erythrocytes of HK and LK dogs is dependent on K concentration because PFK and PK require K for their activities. In the reticulocytes of a LK dog possessing high K and low Na concentrations, PK and PFK activities were markedly elevated from the levels in mature erythrocytes and also dependent on K concentration. As in HK dog erythrocytes, high K concentration is required for glucose metabolism in LK dog reticulocytes. It is suggested that the glycolytic system of LK dog erythrocytes retains the potential to be stimulated with high K concentration even after cell maturation.     

Osmotic Fragility and Erythrocyte Size in Iguana iguana (Sauria – Iguanidae) in Captivity

The erythrocyte size and osmotic fragility were studied in blood samples from adult (n= 40) and juvenile (n= 40) specimens of Iguana iguana. In fresh preparations the erythrocytes were large, oval cells. The largest diameters were 17.06 ± 2.5 mm (juvenile) and 16.20 ± 1.25 mm (adults), and the smallest diameters were 8.23 ± 1.87 mm (juvenile) and 9.00 ± 1.00 mm (adults). In fixed and stained preparations, the largest erythrocyte diameters were 15.28 ± 3.3 mm (juvenile) and 15.51 ± 1.3 mm (adults), and the smallest were 7.82 ± 0.65 mm (juvenile) and 7.85 ± 0.8 mm (adults). The haematocrit value for both juvenile and adult specimens was 27 ± 2%; the red blood cell counts were 1.3 ± 0.43×10¹²/l (juvenile) and 1.2 ± 0.35×10¹²/l (adults). Although no significant differences were observed in the cumulative osmotic curves, the derivative curve of adult specimens indicates the presence of at least two erythrocyte populations with osmotic fragilities at about 70 and 60 mm NaCI, representing 27% and 73% of the total cells, respectively. In samples from juvenile specimens, a major peak at about 70 mm NaCI was observed, which represented 85% of the total cell population. The difference in osmotic resistance between these erythrocyte subpopulations is correlated with their respective geometrical parameters, and compared to that of erythrocytes from other vertebrates.     

Effects of Oxidative Agents on the Erythrocytes from High GSH and Low GSH Sheep

The responses of sheep erythrocytes with high and low reduced glutathione (GSH) content were investigated under extracellular oxidative stress induced by 2,2′-azobis(amidinopropane) dihydrochloride (AAPH) and ferric ion. In terms of GSH depletion, haemolysis, lipid peroxidation and methaemoglobin formation, the extent of oxidant damage to high and low GSH sheep erythrocytes was remarkably similar. These results suggest that red cell GSH content per se is relatively unimportant in susceptibility of sheep erythrocytes to extracellular oxidative insults.     

Relationship Between the Reference Value of the Erythrocyte Sedimentation Rate of the Presenile Population and of Geographical Factors in China

In order to provide a scientific basis for a strictly medical comparison (a ‘unified standard’) of local reference values for erythrocyte sedimentation rate (ESR) among the presenile population in China, the reference values for ESR of healthy persons have been collected, the assays having been performed by the method of Wintrobe. The relationship between the reference value for ESR in the presenile population and geographical factors has been examined. Altitude was found to be the most important factor affecting the reference value for ESR in the presenile population; ESR reference values decrease as the altitude gradually increased, the relationship being highly significant. The method of stepwise regression analysis was used to deduce two regression equations, so that if the geographical factor value of a particular area in China is known, the national reference value for ESR in the presenile population can be calculated by means of these equations. Based on geographical factors, China can be divided into six districts: Qingzang, Southwest, Northwest, Southeast, North and Northeast.     

A Comparison of the Effects of Repeated Anaesthesia with Ether or Isoflurane in Rats

Ether anaesthesia has been used in rodents for routine blood sampling in toxicological studies for many years. Because of the highly flammable nature of ether and the inability to control the depth of anaesthesia, more suitable alternatives are needed. This study was conducted to compare data obtained using ether or isoflurane. Groups of male and female Sprague–Dawley rats, 5 weeks of age, were maintained on a normal diet for up to 25 weeks. Body weights were recorded during the study. Blood was sampled from the retro-orbital sinus under the different anaesthetics from the animals at 8, 12, 21 and from females only at 25 weeks of age for the analysis of standard haematology and biochemical parameters. These animals were killed at 25 weeks of age for histological examination. Body weights were unaffected. The major biochemical and haematological parameters were similar at the various time points with both types of anaesthetic. Minor variations, such as an increase in potassium and a reduction in glucose with isoflurane were seen, but there was no consistent trend. Examination of the liver, kidneys, heart and lungs did not reveal any changes that were considered to be associated with either anaesthetic. Blood was taken for prolactin analysis from a subgroup of animals at 12 weeks of age anaesthetised with ether or isoflurane, and from tail-bled animals without anaesthesia, these animals being killed at 17 weeks of age for histological examination. The level of prolactin at 12 weeks of age was reduced in the isoflurane group particularly in the males. This is considered to indicate that there was less stress. Based on these results, isoflurane is proposed as a suitable alternative to ether.     

Plasma Cystatin C in the Dog: Reference Values and Variations with Renal Failure

Cystatin C is a low-molecular-mass acid protein produced at a constant rate by all nucleated cells and cleared by glomerular filtration. In human medicine it is considered to be a better indicator of renal failure than creatinine. Plasma (Pl-) cystatin C measurements in 179 clinically healthy dogs, using an immunoturbidimetric procedure for human cystatin C, showed a Gaussian distribution with an upper limit of 1.3 mg/l. There were no differences between the sexes. Pl-cystatin C was slightly lower in 1–8-year-old adults than in younger or older dogs. It was also lower in dogs weighing less than 15 kg than in heavier ones. Meals produced a dramatic decrease in Pl-cystatin C that lasted for up to 9h. Pl-cystatin C was elevated in 98% of dogs with renal insufficiency, even in some cases where the Pl-creatinine was normal. Cystatin C may therefore be a useful indicator of renal insufficiency in clinically relevant dogs with borderline P1-creatinine values.     

疏血通联合马来酸桂哌齐特治疗视网膜中央动脉阻塞的 疗效观察

目的 观察疏血通注射液联合马来酸桂哌齐特注射液治疗视网膜中央动脉阻塞的疗效。方法 本研究回顾性分析天津市静海区医院2012年12月~2017年2月收治的31例（31眼）CRAO患者的病历资料,所有患者均给予疏血通注射液联合马来酸桂哌齐特注射液等药物治疗,分析治疗1疗程（14 d）后视力恢复情况。结果 31眼CRAO中治愈3眼,显效7眼,有效17眼,无效4眼,总有效率87.10%。结论 疏血通具有抗凝、溶栓、清除自由基、减轻组织缺血/再灌注损伤的作用,马来酸桂哌齐特可缓解血管痉挛、降低血管阻力、增加血流量、降低氧耗,二者联合应用治疗CRAO疗效显著。     

A Comparative Study of Erythrocytic Total, Free, Short-chain Acyl and Long-chain Acyl Carnitine Concentrations in Arabian Camel ( Camelus dromedarius ) with Different Species

Carnitine plays a critical role in lipid metabolism. Carnitine deficiency may adversely affect the oxidation of fatty acids and further aggravate abnormal lipid metabolism. Its presence is considerable in tissues that utilise fatty acids as an important source of energy, such as the heart and skeletal muscle. The presence of total (TC), free (FC), short-chain acyl (SC) and long-chain acyl (LC) carnitine was shown for the first time in one-humped Arabian camel (Camelus dromedarius) erythrocytes. The results showed that concentrations of FC, AC, SC and TC in camel erythrocytes were significantly higher when compared with bovine, rabbit, rat and humans; however, these carnitine fractions were not significantly different when compared with sheep. Moreover, the concentration of LC in camel erythrocytes was significantly higher when compared with rabbit, rat and humans, but there was no significant difference compared with either sheep or bovine. The results showed that there were significant variations in the ratio of acyl carnitine (AC) to FC among the species erythrocytes studied. The ratio in camel erythrocytes was significantly higher when compared with rat, but there was no significant difference in this ratio in camel erythrocytes when compared with bovine, rabbit, sheep and humans. The higher carnitine concentrations and a higher proportion of AC in erythrocytes of the Arabian camel suggest an adaptive mechanism that could be common to desert animal species.     

The Nationwide Incidence of Retinal Vein Occlusion Following Dialysis due to End-stage Renal Disease in Korea, 2004 through 2013

BackgroundWe investigated the incidence and risk of retinal vein occlusion (RVO) in end-stage renal disease (ESRD) patients on dialysis in Korea.MethodsIn this nationwide cohort study, we used Korean National Health Insurance Service data between 2004 and 2013 for analysis. ESRD patients who started dialysis from 2004 to 2013 and an equal number of controls were selected through propensity score matching. RVO incidence in both cohorts were calculated for 2004–2013 using washout data from 2003. The multivariable Cox proportional hazards model was used to assess the risk of RVO in dialysis cohort. The Kaplan-Meier method was used to generate the cumulative RVO incidence curve. Whether the dialysis modality affects the development of RVO was also evaluated.ResultsIn this study, 74,551 ESRD patients on dialysis and the same number of controls were included. The incidence of RVO was significantly higher in the dialysis cohort than in the control cohort (dialysis = 7.3/1,000 person-years [PY]; control = 1.9/1,000 PY; P < 0.001). The cumulative-incidence of RVO was also significantly higher in the dialysis cohort than in the control cohort (P < 0.001; log-rank test). However, there was no significant difference in the incidence of RVO between the two dialysis methods (P = 0.550; log-rank test).ConclusionThis study provided epidemiological evidence that receiving dialysis for ESRD could increase the risk of developing RVO. We also found a rapid increase in the incidence of RVO with a longer dialysis period. These results strengthen the relationship between retinal vascular disease and renal function.     

Erythropoietin-Hypersecretory State Without Kidney Hypertrophy in Testosterone-Treated Hypophysectomised Rats

An erythropoietin hypersecretory state (EPO-HS) has been defined as a condition evidenced in hypertransfused-polycythaemic rats and mice as a consequence of several treatments imposed before transfusion in which stimulated secretion of EPO is higher than in non-treated hypertransfused-polycythaemic controls at equal levels of polycythaemia. We have recently reported that sustained administration of testosterone induced the appearance of an EPO-HS in female mice, which was accompanied by kidney hypertrophy. Since the erythropoietic effect of androgens has been associated with the latter effect, the present study was performed to test the hypothesis that sustained administration of testosterone could induce an EPO-HS in the hypophysectomised rat model without concurrently increasing renal mass. Normal and hypophysectomised rats were injected with 5 mg of testosterone propionate, given three times per week by the subcutaneous route. Treatment started 90 days after hypophysectomy (performed when rats were 30 days old) to allow the erythropoietic system to reach steady-state conditions in the hypophysectomised animals before androgenic treatment began. The erythropoietic effect of testosterone in the hypophysectomised rats was demonstrated by normalisation of the circulating red cell volume at the end of the treatment period, whilst the undosed hypophysectomised controls gave values of 30% less than normal control rats. Testosterone administration produced a significant increase in renal weight in non-hypophysectomised rats, an effect that was negligible in the hypophysectomised animals. Some of the rats from all groups were hypertransfused at the end of the dosing period. Plasma EPO (pEPO) levels were not significantly different between undosed polycythaemic hypophysectomised and polycythaemic non-hypophysectomised rats exposed to hypobaria for 6 h. However, pEPO was significantly higher in response to exposure to hypobaria in both testosterone-treated hypophysectomised and non-hypophysectomised rats than in their corresponding untreated controls. Thus, data confirmed the hypothesis and suggest that the EPO-HS induced by testosterone should be considered non-specific and independent of kidney hypertrophy.