奥氮平治疗精神分裂症患者血液流变学变异分析

目的:调查住院期间精神分裂症患者使用奥氮平治疗前后血液流变学的指标变化情况.方法:分别于治疗前,使用奥氮平治疗4、8及12周对80例住院的精神分裂症患者的血液流变学进行测定.检测指标包括:全血比低切粘度、全血比高切粘度、血浆粘度、红细胞压积,并对上述指标进行比较分析.结果:全血比低切粘度、全血比高切粘度、血浆粘度在治疗第4、8及12周与治疗前相比,均呈下降趋势,尤其是在治疗第8、12周显著下降(P＜0.01),而红细胞压积的变化无显著性(P＞0.05).结论:血液流变学指标检测可作为精神分裂症的辅助检验项目,也可用作评价其疗效的参考指标.     

肾血管性高血压大鼠脑动脉瘤模型的建立及发生机制初步探讨

目的 :探讨采用易卒中型肾血管性高血压大鼠建立脑动脉瘤模型。方法 :建立大鼠肾血管性高血压模型 ,再电凝切断左侧颈总动脉 ,然后用光镜和电镜观察右侧大脑前动脉和嗅动脉分叉处及附近的组织学改变。结果 :实验组在 2 0 /2 3只大鼠中可见瘤前、早期及进展期的动脉瘤改变 ,与人类囊状动脉瘤的病理改变相似。结论 :结扎一侧颈总动脉造成血流动力学改变的易卒中型肾血管性高血压大鼠可以作为较理想的脑动脉瘤模型。     

慢性精神分裂症患者血液流变学指标的变化及其影响因素

目的为探讨慢性精神分裂症患者的血液流变学指标变化及其影响因素。方法采用锥板式粘度计对85例慢性精神分裂症患者(研究组)及80例健康人(对照组)进行血液流变学指标的检测。结果研究组的全血比低切粘度、全血比高切粘度、血浆粘度明显高于对照组,红细胞压积两组无显著性差异。研究组患者的血液流变学指标不随用药品种、剂量及病程变化而变化。结论慢性精神分裂症患者血液流变学指标高于健康人,并呈现稳定的状态,应引起临床医师重视。     

易卒中型肾血管性高血压大鼠模型

用内径为0.30mm的银夹钳夹双侧肾动脉,复制出一种易卒中型肾血管性高血压大鼠模型,其血压峰值高且稳定在26.7kPa以上,并发生与人类高血压病类似的脑动脉损害:细小动脉纤维素样坏死、透明变性和微动脉瘤形成等,在此基础上,0.56的大鼠自发产生各种类型的脑卒中:脑梗塞、脑出血、蛛网膜下腔出血和混合性脑卒中。本文还着重将这种易卒中型肾血管性高血压大鼠与易卒中型自发性高血压大鼠作了比较。     

术前匀速补液对烟雾病患者血液流变学的影响

目的探讨术前禁饮后开始静脉匀速补液对烟雾病患者血液流变学的影响。方法选取27例拟行间接颅内外血管重建术的烟雾病患者,于入院第二天取空腹血液行血液流变学检查为对照组,并在拟行手术前一天晚上开始禁饮、禁食后予以静脉匀速补液至入手术室前并再次采血行血液流变学检查为实验组;对比两组之间的全血低切粘度、全血中切粘度、全血高切粘度、血浆粘度、红细胞压积、红细胞聚集指数、红细胞刚性指数、红细胞变形指数。结果对照组的血液粘度指标中的全血低切粘度、红细胞压积及红细胞变形指标中的红细胞聚集指数均高于实验组,而对照组红细胞变形指标中的红细胞刚性指数、红细胞变形指数低于实验组,均有统计学差异(P 0.05)。结论术前禁饮后开始静脉匀速补液能够降低烟雾病患者血液粘度并提高红细胞的变形性。     

激光血管内照射对脑梗塞患者血液流变学与血脂的影响

对１２４例脑梗塞患者作血液流变学各项指标的检查，并对其中３６例患者予以低能量Ｈｅ—Ｎｅ激光血管内照射治疗，观察治疗前后血液流变学、血脂和载脂蛋白的变化。结果表明，脑梗塞组与正常对照组比较，前者在全血比粘度低切、全血比粘度高切、全血还原比粘度低切、全血还原比粘度高切以及血浆比粘度等多项均比后者增高，且其差异有非常显著意义（＜０．０１）；而３６例患者接受低能量Ｈｅ—Ｎｅ激光血管内照射治疗后，这些增高的指标均有不同程度的改善（Ｐ＜０．０５或＜０．０１），总胆固醇、甘油三脂、载脂蛋白Ｂ水平在接受治疗后也有下降（Ｐ＜０．０５或＜０．０１）。     

术前匀速补液对烟雾病患者血液流变学的影响

目的 探讨术前禁饮后开始静脉匀速补液对烟雾病患者血液流变学的影响。方法 选取27例拟行间接颅内外血管重建术的烟雾病患者,于入院第二天取空腹血液行血液流变学检查为对照组,并在拟行手术前一天晚上开始禁饮、禁食后予以静脉匀速补液至入手术室前并再次采血行血液流变学检查为实验组;对比两组之间的全血低切粘度、全血中切粘度、全血高切粘度、血浆粘度、红细胞压积、红细胞聚集指数、红细胞刚性指数、红细胞变形指数。结果 对照组的血液粘度指标中的全血低切粘度、红细胞压积及红细胞变形指标中的红细胞聚集指数均高于实验组,而对照组红细胞变形指标中的红细胞刚性指数、红细胞变形指数低于实验组,均有统计学差异（P<0.05）。结论 术前禁饮后开始静脉匀速补液能够降低烟雾病患者血液粘度并提高红细胞的变形性。     

易卒中型肾血管性高血压大鼠凝血和纤溶活性的动态观察

目的　动态观察易卒中型肾血管性高血压大鼠 (RHRSP)血液中凝血系统和纤溶系统的活性改变。方法　双肾双夹法制作RHRSP模型 ,分别于术后 2、4、6、8、1 0、1 2、1 4周取血 ,酶联免疫吸附测定 (ELISA)法检测凝血酶原片段 1 2 (F1 2 )和D 二聚体 (D dimer)含量。结果　 8周始RHRSP血浆中F1 2和D dimer含量逐渐增高 ,明显高于正常对照组 ,且F1 2与D dimer呈正相关 ,F1 2和D dimer均与大鼠收缩压密切相关。结论　血液中凝血系统和纤溶系统活性增高可能是RHRSP出现脑梗死或脑出血 ,甚至是混合性中风的原因之一     

抗精神病药物所致精神分裂症患者血液流变学的变异分析

目的　探讨住院精神分裂症患者在服用抗精神病药物的治疗过程中血液流变学的变异特征。方法　对 10 8例住院的精神分裂症患者分别于治疗前 ,治疗第 4、8及 12周进行血液流变学测定。检测指标包括 :全血比低切粘度、全血比高切粘度、血浆粘度、红细胞压积、红细胞沉降度 ,然后进行比较分析。结果　上述所测项目在治疗第 4、8及 12周与治疗前相比 ,均呈升高趋势 ,尤其是在治疗第 4、8周明显升高 (P <0 0 1)。联合用药组在治疗第4、8及 12周时其全血比低切粘度、全血比高切粘度、血浆粘度、红细胞压积均高于同期单一用药值 ,差异有显著性(P <0 0 1) ;而血沉的变化无显著性 (P >0 0 5 )。结论　住院精神分裂症患者在服用抗精神病药物的治疗期间 ,随着药物的增量有发生心脑血管疾病的危险。作者认为 ,临床应严格遵守用药原则 ,尽可能单一用药     

银夹形状对肾血管性高血压大鼠远期血压及并发症的影响

观察不同形状银夹对肾血管性高血压大鼠远期血压及并发症的影响。　　方法　用内径均为 0 3mm的环形和槽形银夹分别复制双肾双夹型肾血管性高血压大鼠 ,记录两组大鼠在肾动脉狭窄术后 3 0周内的血压水平、自发脑卒中率和心肌梗塞率。　　结果　肾动脉狭窄术后 1～1 4周内 ,两组血压无显著性差异 ,1 4周后环形银夹组血压高于槽形银夹组 ,3 0周内自发脑卒中率和心肌梗塞率也高于槽形银夹组。　　结论　用环形银夹复制的双肾双夹型肾血管性高血压大鼠模型 ,更适用于高血压性心、脑并发症的研究     

丹参多酚酸盐联合依达拉奉治疗急性脑梗死对照研究

目的研究丹参多酚酸盐联合依达拉奉治疗急性缺血性脑卒中临床疗效。方法选自郑州大学附属郑州中心医院2015-06—2017-01收治的急性缺血性脑卒中患者92例。按照随机数字表法分为观察者46例与对照组46例。对照组采用依达拉奉治疗,观察组在对照组基础上联合丹参多酚酸盐治疗。2组疗程均为14d。比较2组治疗疗效,以及治疗前后ADL评分、NIHSS评分、血液流变学及炎症因子水平变化。结果观察组总有效率(93.48%)高于对照组(71.47%,P0.05);观察组治疗后ADL评分高于对照组而NIHSS评分低于对照组(t=19.299、19.523,P0.05);观察组治疗后全血高切还原黏度、血浆黏度值、全血低切还原黏度低于对照组(t=11.804、11.161、9.343,P0.05);观察组治疗后CRP和IL-6低于对照组(t=20.421、31.097,P0.05)。结论丹参多酚酸盐联合依达拉奉治疗急性缺血性脑卒中疗效明显,具有重要临床意义。     

高温高湿环境下颅脑火器伤血液流变学变化研究

目的研究高温高湿环境下颅脑火器伤伤前和伤后2 h血液流变学变化。方法选用杂种狗6只,采取高温高湿环境下手枪弹致颅脑火器伤模型。伤前和伤后2 h抽血进行血液流变学检测及相关血气分析。结果高温高湿环境下颅脑火器伤后血液流变学高切、中切、低切和血浆粘度无明显改变,血液PO2值和PaCO2值下降。结论高温高湿环境下颅脑火器伤后早期血液流变学变化不明显。     

急性脑梗死患者血液流变学及凝血功能的临床意义

目的探讨急性脑梗死患者血液流变学和凝血功能的变化及其临床意义。方法选择75例急性脑梗死为观察组,其中轻度、中度、重度各25例,选择同期75例健康体检者为对照组,比较2组血液流变学和凝血功能,记录观察组不同程度脑梗死患者的血液流变学和凝血功能。结果观察组全血高切黏度、全血低切黏度、血浆黏度和红细胞比积显著高于对照组(P0.05)。观察组血浆纤维蛋白原(FIB)明显高于对照组(P0.05),2组活化部分凝血活酶时间(APTT)和血浆凝血酶原时间(PT)比较差异无统计学意义(P0.05)。重度、中度和轻度患者的全血高切黏度、全血低切黏度、血浆黏度和红细胞比积比较差异有统计学意义(P0.05);重度、中度和轻度患者的FIB比较差异有统计学意义(P0.05)。结论急性脑梗死患者的血液流变学和凝血功能存在异常,且与病情严重程度成正比,监测其动态变化可为临床治疗提供参考价值。     

低分子肝素联合丹参注射液治疗急性脑梗死的效果分析

目的探讨低分子肝素和丹参注射液联合治疗急性脑梗死的临床效果。方法选取2012-12—2015-01我院诊治的急性脑梗死患者95例,随机分为研究组(n=48例)和对照组(n=47例),对照组实施基础治疗与丹参注射液,观察组加用低分子肝素治疗。比较2组治疗前后血液流变情况、神经功能改变情况(NIHSS评分),并评定临床疗效、并发症情况。结果2组治疗后血液流变学指标(纤维蛋白原、红细胞比积、血浆黏度、全血低切黏度、全血高切黏度)均明显低于治疗前(P0.05),且研究组较对照组降低更明显(P0.05);治疗后7、14、28d2组NIHSS评分均较治疗前明显降低(P0.05),且研究组各时点NIHSS评分较对照组更低(P0.05);研究组与对照组总有效率分别为91.67%和74.47%,研究组高于对照组(P0.05);2组并发症发生情况无明显差异(P0.05)。结论低分子肝素联合丹参注射液治疗急性脑梗死,患者脑部循环明显改善,效果显著,值得推广。     

Chronic blood hyperviscosity in subjects with acute stroke, transient ischemic attack, and risk factors for stroke

The origin and significance of blood hyperviscosity in subjects with acute stroke has been controversial. It has been argued that viscous abnormalities simply reflect either elevated hematocrit or an acute-phase response to the stroke itself. To address these issues, we measured the factors that determine blood viscosity in a cross-sectional study of 430 subjects, including 135 with acute stroke, 89 with acute transient ischemic attacks of the brain, 115 with recognized risk factors for stroke, and 91 healthy controls. The at-risk group was balanced with the acute stroke group for types of risk factors and medication usage, and all four groups were balanced for age. The viscosity of whole blood at low rates of shear and the plasma viscosity were significantly elevated in both groups with cerebrovascular symptoms and in the at-risk group compared with the healthy controls. The severity of hyperviscosity was stroke group greater than transient ischemic attack group greater than at-risk group greater than healthy controls. Increased viscosity of whole blood was associated with an elevated plasma fibrinogen concentration and with a decreased albumin/globulin ratio. This study provides evidence that blood hyperviscosity is present not only in subjects with acute brain infarction, but also in those with risk factors for stroke, and that these abnormalities are, to a considerable degree, chronic.     

精神分裂症有无家族史患者的血液流变学比较

目的：探讨精神分裂症患者有无家族史血液流变学特征。方法：对150例精神分裂症按一级亲属家族史阳性,二、三级亲属家族史阳性,家族史阴性分为三组,比较其血液流变学差异,并与70名健康人对照,结果：精神分裂症患者与健康人相比呈显著的高粘滞血症,阴性家族史患者的全血粘度、血浆粘度,低切还原粘度及纤维蛋白质显著高于一级亲属家族史阳性患者（P＜0．05,P＜0．01）;全血粘度显著高于二、三级亲属家族史阳性患者（P＜0．01）,一级与二、三级亲属家属史阳性患者血液流变学指标比较无显著性差异（P＞0．05）。结论：精神分裂症患者血液流变学改变与家族史有关。     

Hypoplasia,stenosis and other alterations of the vertebral artery: does impaired blood rheology manifest a hidden disease?

Objectives – The clinical relevance of abnormal vessel findings in the posterior circulation is still a matter of controversy. Patients and methods – We compared 48 patients displaying sonographic abnormalities of one vertebral artery, i.e., vertebral artery hypoplasia in 24 cases, stenosis in 13 cases, plaques in 11 cases, with 25 healthy subjects in terms of whole blood viscoelasticity and plasma viscosity. Results – All patients with stenosis and plaques suffered from clinical signs and symptoms of ischemic cerebrovascular disease, predominantly in the posterior circulation. Free of acute clinical symptoms were 5 of the 24 patients with hypoplasia. Highly statistically significant differences in blood viscoelasticity were found between the patients and the healthy subjects. As regards differences between the groups, whole blood viscoelasticity was most impaired in stenosis, shear resistance was significantly higher in stenosis compared to hypoplasia. Symptom-free patients with one-sided vertebral artery hypoplasia had a significantly better, nearly normal blood rheology at a low shear rate (10/s), compared to clinically symptomatic patients with hypoplasia. Conclusion – The results of the present study offer some evidence that altered hemorheology may be associated with symptomatic vertebrobasilar occlusive disease.     

The relationship of plasma fibrinogen, erythrocyte flexibility and blood viscosity

Measurements have been made of plasma fibrinogen concentration, erythrocyte flexibility and blood viscosity at shear rates from 5.75 to 230 sec-1 during and following surgery. In the post-operative period the plasma fibrinogen level in the patient rose to over 1,000 mg/dl and because there were subsequent complications, only returned to normal after 4 weeks. There was an associated change of erythrocyte flexibility, with a correlation coefficient of 0.98. The blood viscosity also varied with the plasma fibrinogen level, the effect being more pronounced at low shear rates. The internal viscosity of the red blood cell, calculated from the plasma viscosity and whole blood viscosity at 230 sec-1, decreases with increasing plasma fibrinogen concentration, in agreement with the direct measurements made of erythrocyte flexibility. It is proposed that at high shear rates an increase in plasma viscosity due to an elevation of fibrinogen concentration, is offset by a decrease in the rigidity of the erythrocytes, and these 2 effects counter-balance.     

Another possible determinant for ischemic stroke with nonvalvular atrial fibrillation other than conventional oral anticoagulant treatment: The relationship between whole blood viscosity and stroke☆

ObjectivesPatients with nonvalvular atrial fibrillation (NVAF) still experience ischemic stroke despite recommended medications and this could be the consequence of increased whole blood viscosity (WBV). We evaluated the predictive value of WBV for stroke in patients with NVFA despite receiving oral anticoagulant (OAC) therapy.MethodsOne thousand and forty-three NVAF patients on OAC medication were followed up for median 36.13 ± 18.31 months. WBV was calculated according to the validated de Simone's formula.ResultsWBV was significantly higher in stroke group when compared to non-stroke group at both low shear rate (LSR) and high shear rate (HSR). Multiple regression analysis demonstrated an independent association between WBV and stroke when adjusted for other risk factors.ConclusionsWBV appears to be a profitable predictor of ischemic stroke in patients with NVAF receiving OAC.