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。     

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.     

33例主动脉夹层动脉瘤的误诊分析

OBJECTIVE: To compare the clinical characteristics, clinical course and laboratory findings of diagnosed and misdiagnosed cases of aortic dissection (AD). METHODS: The data of 33 cases of AD were collected for a retrospective review. All the patients underwent examination with X-ray and B-type ultrasound, and diagnosis of the suspected cases was further verified CT and magnetic resonance imaging according to the criteria of presence of false lumen or free valves. Diagnosis of AD was established in 18 of the 33 patients, including 14 male and 4 female patients aged from 20 to 79 years with a mean of 55.8+/-11.4 years. Misdiagnosis occurred in 15 patients including 12 male and 3 female patients aged 22-75 years with a mean of 56.2+/-10.8 years. RESULTS: No significant differences were found between the diagnosed and misdiagnosed groups in terms of age, sex, hypertension, coronary heart disease, chest pain, heart murmur, pericardial effusion, pleural effusion, average systolic and diastolic pressure, white blood cell count, creatine phosphokinase (CK) and its isoenzyme CK-MB, or De Bakey type III (P>0.05). Significant differences in peripheral large blood vessel murmur, asymmetric blood pressure of the arm and leg, ST segment variation, arrhythmia, and De Bakey types I and II were noted between the two groups (P<0.05). In cases misdiagnosed as acute coronary syndrome, ST segment variation, creatine kinase, arrhythmia, and white blood cell count were significantly different from those in cases of diagnosed as AD (P<0.01), but CPK-MB and cardiac troponin I were comparable. CONCLUSION: The initial symptoms, disease course, cardioelectrographic changes and creatine kinase of AD can be easily confused with those of acute coronary syndrome, and special attention should be given to their differentiation.     

健康儿童血液触变特性的研究

With low shear-30 rheometer, the authors used a modified protocol to measure thixotropic parameters of whole blood from 200 healthy newborns and children, so as to suggest the normal range of blood thixotropic parameters in four age groups, namely, the newborns, 1 year- group, 5 year- and 10-15 year group. The results demonstrated that the thixotropic parameters in the newborn group were higher than those in other three groups. However, these thixotropic parameters in the group 1-10 years were lower than those in the 10-15 year group. No significant sex differences were noted among the fore three groups, but sex differences appeared obviously in the 10-15 year group. It implied that the changes relying on the age is consistent with children's growth, development and physiologic activities.     

经颅多普勒超声对糖尿病的脑血流检测分析

目的　探讨经颅多普勒 (TCD)在诊断和预测糖尿病患者脑血管病变中的临床意义。　方法　采用TCD诊断仪对 6 4例 5 0岁以上 2型糖尿病患者及 5 9例同年龄段正常对照组进行脑血流检测。　结果　糖尿病组的 PI值增高 (P<0 .0 1～ 0 .0 5 ) ;血流速度亦增高 ,其中 MCA、ACA、PCA的 Vs、Vm、Vd及 VA的 Vs与对照组比较 ,差异有显著性 (P<0 .0 1～ 0 .0 5 ) ,BA的 Vs、Vm、Vd及 VA的 Vm、Vd与对照组比较差异无显著性 (P>0 .0 5 ) ;糖尿病组颈内动脉系统血管 PI值较椎基动脉系统血管 PI值明显增高 (P<0 .0 1)。　结论　 TCD对糖尿病颅内动脉血流动力学的改变灵敏度较高 ,在诊断糖尿病患者脑血管病变、预测和减少脑血管意外方面有着重要的临床意义