血液保存时间对库存血流变特性的影响

目的：观察血液保存时间对血液流变特性的影响。方法：选择５６例 健康献血员。常规采血及保存,取新鲜血（采集后１小时）、１周上周及３周４个时相 点。检测全血粘度（高切、中切、低切）、血浆粘度、血球压积及ＲＢＣ聚集指数（ＡＩ） 和刚性指数（ＩＲ）。结果：红细胞压积、中切粘度在保存３周内无显著变化,高切粘度 在第三周显著升高,而低切粘度下降。血浆粘度随保存时间延长进行性下降。ＡＩ在 第３周显著降低而ＩＲ在第２周时则升高,第３周更为明显。结论：结果提示库存血 保存时间的延长对全血粘度和 ＲＢＣ的变形性及聚集性产生显著影响,特别在第 ３ 周出现非常显著变化,ＲＢＣ变形性改变影响ＲＢＣ的运氧功能,降低了输血效果。     

库存血红细胞流变特性的变化

目的 观察血液保存时间对红细胞流变特性的影响。方法 选择56例健康献血员,常规采血及保存。取新鲜血(采集后1小时)、采集后1周、2周及3周的血液于4个时相点．用MOPEL R80型电脑全自动血液流变学测定仪．检测全血高切粘度、中切粘度、低切粘度、红细胞压积及RBC聚集指数(AI)和刚性指数(IR)。结果 红细胞压积、中切粘度在保存3周内无显变化,高切粘度在第3周显升高．而低切粘度则下降。AI在第3周显降低;IR则在第2周时显上升．第3周更为明显。结论 随库存血保存时间的延长．对RBC的变形性及聚集性会产生重要影响．特别是在第3周出现显性变化。     

库存全血保存期间血液流变学特性的变化

目的 观察库存全血保存期间血液流变学特性的变化。方法 随机选择20例献血者．常规采血保存,分别于采集后10个时间点：2h,24h、3d、5d、7d、10d、14d、21d、28d、33d检测全血粘度（高切、中切、低切）及红细胞压积。结果 库存全血保存24h后高、中切粘度的升高有显著性（P〈0．05）,14d后低切粘度的升高也有显著性（P〈0．05）,但红细胞压积的变化无显著性。结论库血随存放时间的延长,血液流变学特性有显著性改变。     

光量子疗法并丹参治疗血液高粘滞综合征的综合观察

高粘滞综合征患者92例,随机分为常规治疗的对照组（46例）和在常规治疗基础上加用光量子疗法（UBIO）合并丹参静脉滴注的治疗组（46例）,进行疗效观察。结果表明：对照治疗组治疗前后血液流变学指标：低切粘度、低切还原粘度、红细胞压积、血浆粘度、聚集指数均有显著（P＜0．01或P＜0．001）,提示UBIO明显改善高粘滞综合征患者的血液粘度,从而改善微循环。     

镇心痛口服液对缺血性心脏病患者心功能及血液流变学的影响

目的：探讨镇心痛口服液对缺血性心脏病患者心功能及血液流变学的影响。方法：６４例缺血性心脏病患者口服镇心痛口服液治疗３０天。用电脑超声仪观察治疗前后患者心功能：射血分数（ＥＦ）、心输出量（ＣＯ）、心脏指数（ＣＩ）、左室舒张末期容积（ＬＶＥＤＶ）和左室收缩末期容积（ＬＶＥＳＶ）；血液流变学观察全血高、低切比粘度、血浆比粘度、红细胞压积及纤维蛋白原的变化。结果：ＥＦ治疗后较治疗前显著升高（Ｐ＜０．０１），ＣＯ、ＣＩ升高（Ｐ均＜０．０５），ＬＶＥＳＶ、ＬＶＥＤＶ降低（Ｐ均＜０．０５）；全血高切比粘度、血浆比粘度、纤维蛋白原均非常显著下降（Ｐ均＜０．０１），全血低切比粘度、红细胞压积均明显下降（Ｐ均＜０．０５）。结论：镇心痛口服液对缺血性心脏病患者的心功能及血液流变学具有明显改善作用。     

白细胞滤除对保存期内红细胞流变性和形态的影响

目的 探讨白细胞滤除对保存期红细胞流变性及形态的影响.方法 选择30名健康献血者的血液制备成红细胞悬液,随机分为实验组(n=30):使用去白细胞输血过滤器去除红细胞悬液中的白细胞(简称滤白组);对照组(n=30):未滤白的红细胞悬液;2组一起常规保存.取采血后d0、d7、d14、d21、d28、d35的血标本作白细胞(WBC)和红细胞计数(RBC)、红细胞压积、血液高剪切力、低剪切力及细胞形态学检测.结果 过滤前后红细胞悬液内的WBC为(6.80±0.85)(× 109/L) vs (3.12±0.26)(×106/L) (P ＜0.01);保存d21时低、高切粘度分别为:对照组(11.28±1.88)1/s、(2.85±0.29)200/s,滤白组(12.36±1.57)1/s、(2.93±0.22) 200/s,较保存1～2周明显上升(P＜0.05),但组间比较未见明显著变化(P＞0.05);瑞氏染色结果显示2组细胞形态也有不同变化,滤白组红细胞形态保存较好.结论 白细胞滤除能有效减少白细胞崩解产物或分泌因子对红细胞形态的影响.     

癫痫病人血液流变学研究

文中报告44例积痫病人血液流变9项指标和血纤维蛋白原的分析研究。结果示：红细胞压积、全血低切及高切粘度、血浆粘度和纤维蛋白原均显著高于健康对照组（P＜0．０１）。说明癫痫病人的血液具有粘稠滞的特性。此特性与微循环障碍互为因果．从而提出对癫痫尤其是对频繁发作和持续状态的病人，在抗癫病治疗的同时注重疏通微循环，改善血液流变性是极为可取的。     

两种采血方法对血液流变学指标影响的比较

目的：比较使用一次性自动静脉采血器（采血器）和普通10ml注射器两种方法在采集血液流变学标本中对检测结果的影响。方法：选择医嘱需抽查血液流变学的志愿30例，随机分配同一位患的两次抽血，一次使用注射器，一次使用采血器。盲法检测高切（200／s）及低切（3／s）全血粘度、血浆粘度、红细胞压积、纤维蛋白原含量。结果：注射器组较采血器组低切全血粘度、血浆粘度明显增高（P＜0．05）。结论：采血器采血法较注射器采血法对血液流变学指标影响小，应为临床首选。     

He-Ne激光血管内照射对脑梗塞血液流变性影响

对４７例脑梗塞患者应用低能量Ｈｅ—Ｎｅ激光血管内照射治疗结果 表明：治疗前后的高切、低切全血粘度、血浆粘度、红细胞聚集指数、红细胞压积、全 血还原粘度、血沉方程 Ｋ值及Ｑ值均有显著性差划（Ｐ＜０．０１或 Ｐ＜０．０５），提示 ＩＬＩＢ疗法能改善脑梗塞患者的血液流变性。     

2型糖尿病患者糖化血清蛋白水平与血流变学相关性的研究

目的 观察不同糖化血清蛋白水平的糖尿病患者与血液流变学各指标的相关性。方法 对所有病例空腹血液检查。主要指标为糖化血清蛋白和血液流变学各参数（纤维蛋白原、红细胞压积、浆粘度、全血低切粘度）．比较糖化血清蛋白正常组及增高组与血液流变学各指标是否有统计学差异。结果 两组人口学指标无统计学差异（p〉0．05）。两组糖化血清蛋白、纤维蛋白原、红细胞压积、血浆粘度、全血低切粘度经检验有显著差异（p〈0．01）。结论 2型糖尿病患者短期血糖控制状况不佳与血液粘滞度恶化显著相关。     

中分子羟乙基淀粉200／0．5溶液对创伤休克病人血液流变特性的影响

目的：观察创伤失血性休克病人麻醉手术前快速输入10％羟乙基淀粉（10％HES 200／0．5）溶液后,血液流变学及血液循环指标的变化。方法：选择交通事故致创伤失血性休克病人30例（失血量10－30ml.kg^-1),于输液前后分别采取静脉血3ml,检测血液流变学指标：低切全血粘度（30．S^-1),高切全血粘度（200．s^-1),Hct,血浆粘度,红细胞聚集指数,红细胞变形指数,全程监测平均动脉压,心率,脉搏氧饱和度（SpO2),统计术中异体血液制品用量,结果：输注10％HES溶液后患者全血粘度明显降低,Hct降低,红细胞聚集指数降低 和红细胞变形指数升高等均有显著差异（P＜0．05或P＜0．01）,平均动脉压显著升高及心率明显减慢（P＜0．05或P＜0．01）,术中输异体血量明显少于失血量。结论：输入15－20ml.kg^-1的10％HES溶液能降低低血容量休克病人的全血粘度,Hct和红细胞聚集指数,从而优化病人的血液流变状态;迅速提高平均动脉压,减慢心率,改善微循环灌注,预防创伤失血性休克并发症,改善病人预后。     

Filtration of RBC units:effect of storage time and temperature on filter performance

BACKGROUND: The influence of time, temperature, and rate of filtration on the efficacy of WBC reduction of RBC units was studied in a controlled, paired-donor format. STUDY DESIGN AND METHODS: Ten donors underwent whole-blood phlebotomy on two to four occasions each. Units were filtered (RCXL-1, Pall Biomedical) under laboratory conditions and gravity flow as follows: 1) after 0 to 2 hours of storage at 22 degrees C, 2) after 7 to 8 hours at 22 degrees C, 3) after 14 days of storage at 4 degrees C, and 4) under mock bedside conditions after 14 days of storage at 4 degrees C. Prefiltration and postfiltration cell counts and prefiltration WBC CD11a expression were assessed on Days 0 and 14. RESULTS: WBC content before filtration was 2.20 and 2.34 x 10(9) (p>0.05) for units stored for 2 and 8 hours (Groups 1 and 2) and declined to 52.8 and 7. 57 x 10(4) (p<0.01) after filtration. The efficacy of WBC reduction in units stored for 14 days was similar to that in units stored for 8 hours, but absolute postfiltration WBC counts were significantly lower because of a 0.6 log reduction in the starting WBC count after 14 days of storage (postfiltration WBC content of 1.02 and 2.31 x 10(4) for units filtered under laboratory vs. bedside conditions [p>0.05]). Filtration under bedside conditions was associated with a greater degree of variation in residual WBC counts than laboratory filtration. WBC reduction by filtration was significantly greater in units stored for at least 8 hours (Groups 2, 3, and 4) than in those stored for less than 2 hours (4.59 log vs. 3.83 log reduction in WBC content, p<0.05). Surface expression of leukocyte function antigen 1 as measured by CD11a was similar in all groups. CONCLUSION: WBC reduction of RBC units by filtration was least effective when performed within 2 hours of collection. Efficacy of WBC reduction increased significantly after the units were stored for 8 hours to 14 days, without significant differences between these storage intervals. Laboratory filtration yielded more consistent results than did mock bedside filtration. Temperature and filtration rate had no effect on the efficacy of WBC reduction by filtration.     

奥美沙坦酯对原发性高血压患者血流动力学的影响

目的观察奥美沙坦酯对原发性高血压患者血流动力学的影响。方法 32例原发性高血压患者(奥美沙坦组)服用奥美沙坦20~40 mg/d10个月,另选30例原发性高血压患者服用复方降压片作为对照组,观察治疗前、后血流动力学指标的变化。结果奥美沙坦组服用奥美沙坦10个月后血压明显下降(P<0.01),全血低切黏度(ηb)、血浆黏度(ηp)及红细胞聚集指数(AI)全血低切还原黏度红细胞电泳纤维蛋白原(Fib)均显著降低(P<0.01);全血高切黏度、全血高切还原黏度、红细胞比容和红细胞刚性指数(RRI)也有所下降,但无统计学意义(P>0.05)。对照组治疗后仅ηb、ηp及AI较治疗前显著降低。结论原发性高血压患者服用奥美沙坦酯后在血压显著降低的同时,其红细胞聚集性Fib下降和红细胞变形能力增强,红细胞比容、血黏度降低。     

急性脑梗死患者治疗后全血细胞参数及血液流变性指标的变化

背景:血液流变学指标的异常改变与血管损伤、微循环障碍以及血栓的形成和发展具有密切的联系。目的:探讨急性脑梗死患者血液流变学及全血细胞25项参数的变化。设计:同期对照病例分析。单位:新乡医学院医学检验系。对象:①脑梗死组:2002-01/12新乡医学院第二附属医院神经内科收治的急性脑梗死患者127例,均为首发患者,病程4～12h,经头颅CT证实为脑梗死,其诊断标准符合1995年第四届全国脑血管病学术会议修订的各类脑血管病诊断要点。②正常对照组:选择同期在本院体检血压正常,无心、脑、肾疾病及糖尿病的健康人53例。两组年龄、性别比较差异无显著性意义。方法:①脑梗死组患者于入院当天进行降纤治疗,注射2支10u克栓酶,分别于第3,5,7天再次注射1支10u的克栓酶。②两组均用肝素钠抗凝的真空采血管抽取空腹静脉血5mL和EDTA-K2抗凝血2mL,测定切变率分别为200s-1,30s-1,5s-1和1s-1时的全血黏度值、全血高切还原黏度、全血低切还原黏度、全血高切相对指数、全血低切相对指数、血沉方程K值、血浆黏度、红细胞压积、血沉、红细胞聚集指数、红细胞刚性指数、红细胞变形指数、白细胞计数、红细胞计数、平均红细胞体积、红细胞分布宽度、血红蛋白含量、平均红细胞血红蛋白含量、平均红细胞血红蛋白浓度、血小板计数、平均血小板体积、血小板分布宽度。③脑梗死组患者首次检测时间为发病24h内(急性期),并于治疗2周后(恢复期)复查上述指标。主要观察指标:两组血液流变学及全血细胞参数的比较。结果:脑梗死组127例,急性期全部进入结果分析,恢复期有5例患者因出院未能复查。正常对照组53例均无脱落。①与正常对照组比较,除红细胞分布宽度、平均红细胞血红蛋白浓度外,脑梗死组患者急性期各项指标差异均有显著性意义(P<0.05,0.01);脑梗死组患者恢复期的全血低切黏度、全血低切还原黏度、全血高切相对指数、全血低切相对指数、血浆黏度、红细胞压积、红细胞聚集指数、白细胞计数、平均红细胞血红蛋白含量均已恢复到正常水平(P>0.05)。②与急性期比较,脑梗死组患者恢复期红细胞计数、平均血小板体积均明显降低(P<0.05),其余指标基本相似(P>0.05)。结论:急性脑梗死患者存在着血液流变学指标的普遍异常,提示血液流变学及血细胞参数异常可能与脑梗死的发生有关。     

Prestorage WBC filtration of RBC units with soft-shell filters: filtration performance and impact on RBCs during storage for 42 days

BACKGROUND: The introduction of universal WBC filtration of RBCs prior to storage is currently under consideration in many countries, as it is thought to minimize the incidence of transfusion-associated adverse effects. Centrifugation of blood containers with newly developed soft-shell WBC filters is more convenient, and so of great interest. STUDY DESIGN AND METHODS: Two different quadruple blood pack systems with integrated soft-shell WBC filters were compared (Sepacell OptiPure RC, Baxter Biotech, vs. LCR 5, Maco Pharma). Buffy coat-depleted RBC units were investigated from whole-blood donations that were held for 2 to 3 hours before centrifugation and subsequent filtration at 22 degrees C (Group 1, OptiPure RC, 450 mL; Group 2, LCR 5, 450 mL; Group 3, OptiPure RC, 500 mL; Group 4, LCR 5, 500, mL, n = 12 per group). Filtration performance was analyzed, and the impact of WBC filtration on hemolysis rate, Hb content, pH, supernatant potassium, ATP, and 2,3 DPG was investigated weekly during storage for 42 days. RESULTS: Filtration reduced the WBC count by 4.4 to 5.1 log. Mean +/- SD Hb content was 44.7 +/- 3.0, 41.2 +/- 3.3, 53.1 +/- 5.0, and 51.5 +/- 6.3 g per unit, respectively, with a corresponding mean RBC recovery after filtration of 71.0 +/- 3.0, 68.3 +/- 3.3, 76.6 +/- 1.7, and 68.9 +/- 4.5 percent. WBC filtration resulted in a significant reduction of Hct (0.10-0.14) in all four groups. Investigation of all RBC storage variables revealed acceptable values throughout the storage for 42 days. CONCLUSION: WBC filtration with two newly developed soft-shell filters showed acceptable WBC-reduction efficacy without any difference between filter types in buffy coat-depleted RBCs from 450- and 500-mL whole-blood donations. However, the application of both filters resulted in an unacceptably low RBC recovery after filtration, which was particularly evident with the LCR5 filter. Our findings raise concern that WBC reduction with these filters may result in the production of RBCs with an inappropriately low Hb concentration.     

WBC filtration of whole blood after prolonged storage at ambient temperature by use of an in-line filter collection system

BACKGROUND: Before-storage WBC reduction by filtration appears to be an effective way to prevent transfusion-associated complications. It also has superiority over WBC reduction at the time of transfusion (bedside), due to the many variables associated with such practice and the difficulty in performing adequate quality control. To determine the adaptability of collection systems containing in-line filters to the current blood collection strategy, the feasibility, efficiency, and quality of before-storage WBC reduction of whole blood (WB) units were evaluated, following their prolonged storage at ambient temperature prior to component preparation, by use of an integral in-line filter. STUDY DESIGN AND METHODS: Blood was collected from random donors into quadruple blood pack units with an integral in-line filter and divided into three groups, according to storage conditions. WBC reduction was performed at room temperature, on WB units after storage at ambient temperature either for less than 8 or up to 18 hours on 1,4-butanediol cooling trays or for 18 hours in the cold. RESULTS: All the filtration procedures met the AABB threshold of less than 5 x 10(6) residual WBCs per unit and the European requirements for WBC counts of less than 1 x 10(6) WBCs per unit. The average filtration time was less than 22 minutes in all units studied. Filtration time and blood flow rate were both significantly longer, and RBC loss was significantly higher in WB units that were filtered after prolonged storage in the cold. CONCLUSIONS: Adequate before-storage WBC reduction can be achieved when performed on WB units, which were stored at ambient temperature for 18 hours, by use of an in-line filtration system. The procedure, performed under relatively simple logistics, results in good-quality, standard components, which require no further modifications when supplied to the transfusion services.     

非胰岛素依赖型糖尿病患者的血液流变学及细胞流变学分析

目的：探讨非胰岛素依赖型糖尿病(Ⅱ糖尿病，NIDM)患者的血液流变学和细胞流变学改变。方法：对380例Ⅱ糖尿病患者进行全血粘度(高切、低切)和血浆粘度、血沉、红细胞压积、红细胞电泳时间、纤维蛋白原及红细胞变形指数和聚集指数等有关血液流变和细胞流变指标进行测定。结果：NIDM患者全血粘度(高切、低切)和血浆粘度增高，血沉增快，红细胞压积增高，红细胞电泳时间延长，纤维蛋白原增加，红细胞变形能力下降，红细胞聚集增强。结论：NIDM患者存在有明显的血液流变和细胞流变的异常。     

磁场暴露对兔血液流变特性及血脂水平的影响

背景目前许多关于磁场生物效应的研究指出,低强度脉冲电磁场(low-intensity pulsed electromagnetic fields,LPEF)能改善血液流变学的指标、对心血管病能起到预防作用,但对其机制的阐述尚不明确.目的探讨低强度脉冲电磁场暴露对兔血液流变特性及血脂水平的影响,研究LPEF预防心血管疾病的机制.设计随机对照的实验研究.地点、材料和干预本实验的全过程在解放军第四军医大学实验动物中心完成.实验动物采用24只雌性5月龄新西兰大耳白兔(解放军第四军医大学实验动物中心提供).动物被随机分为正常组、模型组、磁场组,正常组用正常饲料,模型组、磁场组用高胆固醇饲料饲养.其中磁场组饲养于磁场环境中,暴磁时间为10h/d,所采用激励磁场的强度为4×10-4T,频率为15Hz.饲养8周后测定其血液流变特性和血脂水平等指标.主要观察指标LPEF对兔血液流变学各项指标(血细胞比容、血浆黏度、全血高切黏度、全血低切黏度、高切还原黏度、低切还原黏度、红细胞聚集指数)以及血脂水平(胆固醇、三酰甘油、高密度脂蛋白等指标)的影响.结果模型组与正常组比较,血液流变学各项指标及血脂水平差异具有显著性意义(t=2.147～2.859,P＜0.05);磁场组与模型组比较,血清中胆固醇[模型组(14.71±0.22)mmol/L,磁场组(8.75±1.32)mmol/L]、三酰甘油[模型组(2.69±0.03)mmol/L,磁场组(0.70±0.16)mmol/L]以及血液流变中的血细胞比容、血浆黏度、全血低切黏度等指标降低显著(t=3.478～14.253,P＜0.01),而高密度脂蛋白升高显著(t=11.345,P＜0.01).结论低强度脉冲电磁场能够显著降低血脂、血液流变学等指标,提高血液流动性,对心血管疾病有良好的预防作用.     

自血光量子疗法对血液流变学指标的影响

３３例心脑血管病患者经自血光量子治疗一个疗程，观察治疗前后血液流变学指标的变化，发现治疗后全血高切粘度、全血低切粘度、血浆比粘灰、红细胞压积、红细胞聚集指数、血沉、纤维蛋白原和红细胞电泳时间 ８项指标均有下降，与治疗前相比有显著性差异，提示自血光量子治疗可有效地降低血液粘度，临床上可应用于伴随血液粘度增高的疾病。