精神分裂症不同亚型患者的血液流 变学实验研究

目的探讨精神分裂症不同亚型血液流变学特点及差异。方法对１４０例精神分裂症患者进行血液流变学检测,与６０例健康人对照,并按阴阳性症状分型相互比较。结果精神分裂症患者全血粘度、刚性指数、低切还原粘度、纤维蛋白原、电泳率均显著高于健康对照。红细胞电泳时间、脑血流量显著低于健康对照。精神分裂症阳性症状为主型全血粘度、低切还原粘度显著高于混合型,混合型显著高于阴性症状为主型。刚性指数、红细胞聚集指数阳性症状为主型和混合型显著高于阴性症状为主型,但阳性症状为主型与混合型差异无显著性。结论血液流变学性质作为精神分裂症的生物学指标,其变化在一定程度上与阴阳性症状分型有关     

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.     

不同病程精神分裂症的血液流变学改变

目的探讨精神分裂症患者的血液流变学改变。方法对１４０例精神分裂症（包括分裂样精神病），６０例健康人做血液流变学的前瞻性研究。结果精神分裂症的全血粘度、刚性指数、低切还原粘度、纤维蛋白原、电泳率显著高于健康人；红细胞电泳时间、脑血流量显著低于健康人。病程短者的血小板粘附率增高明显；病程长者全血粘度及电泳率增高亦明显。结论血液流变学的性质改变有助于精神分裂症的诊断及估计转归     

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。     

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     

格拉斯哥昏迷评分和血液流变学变化对外伤继发大面积脑梗死的评估价值

目的探讨格拉斯哥昏迷评分和血液流变学变化在颅脑外伤后继发大面积脑梗死患者中的应用及评估预后的价值。方法 2013—2015年收住我院的颅脑外伤患者57例,依据术后1周内是否发生大面积脑梗死将其分为研究组(n=18)与对照组(n=39),观察手术前后2组患者格拉斯哥昏迷评分、血浆纤维蛋白原及血浆黏度等血液流变学指标变化情况。结果治疗前对照组格拉斯哥昏迷评分及血液流变学指标均优于研究组(P0.05)。研究组治术后格拉斯哥昏迷评分低于术前(P0.05),但血浆纤维蛋白原、全血高切黏度及血浆黏度等血液流变学指标高于术前(P0.05)。结论格拉斯哥昏迷评分和血液流变学指标可对颅脑损伤后并发大面积脑梗死进行预测。     

分裂样精神病与精神分裂症的血液流变学研究

为探讨分裂样精神病与精神分裂症的血液流变学改变,对25例分裂样精神病、115例精神分裂症及60例健康人做血液流变学检测的前瞻性研究。结果,无论分裂样精神病与精神分裂症的全血粘度、刚性指数、低切还原粘度、纤维蛋白原、电泳率都显高于正常人。分裂样精神病与精神分裂症比较,除全血粘度（101/s）、血浆压积的改变存在一定程度上的差异,以及前的血小板粘附率高于后外,其余各项指征相似,说明分裂样精神病与精神分裂症具有相似的血液流变学改变,从一个侧面提示两可能是同源性疾病。     

精神分裂症患者血液流变学的病情分组研究

目的探讨不同病情精神分裂症患者血液流变学差异,并了解血液流变学改变与病情的关系。方法 对126例符合CCMD—2—R的精神分裂症病人进行BPRS评定和血液流变学检测,并依BPRS总分的均数±1/2标准差进行病情分组比较血液流变学差异,同时与60名健康人对比。结果 精神分裂症者与健康人相比呈显著的高粘血症;病情重度组的全血粘度、刚性指数、红细胞聚集指数、血小板粘附率、低切还原粘度和纤维蛋白原显著高于病情轻度组;BPRS总分及焦虑忧郁因子分与全血粘度、红细胞聚集指数、血小板粘附率、低切还原粘度、纤维蛋白原呈显著正相关关系。结论 精神分裂症的血液流变学改变在一定程度上反映病情的变化。     

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。     

Ⅰ型与Ⅱ型精神分裂症的血液流变学改变

目的 探讨精神分裂症病人的血液流变学变化。方法 对１００例精神分裂症，５０名健康对照组作血液流变学检测的前瞻性研究。结果 精神分裂症的全血粘度，红细胞沉降率，血沉方程Ｋ值、纤维蛋白质均高于正常人（Ｐ〈０．０５）。Ｉ型精神分裂症的纤维蛋白原、全血度、特别是低切粘度显著高于Ⅱ型精神分裂症（Ｐ〈０．００１）。结论定期检查血液流变学性质，有助于阐明明精神分理解症的发病因素，疾病分型，指导临床用药，监测复发     

Hemorheological factors in cerebral ischemia.

We investigated 100 consecutive cerebral ischemia patients for hemorheological alterations. We measured whole and adjusted blood viscosity at 75 and 1,500 sec-1, plasma viscosity, red blood cell aggregation by the zeta sedimentation ratio, and red blood cell deformability using the centrifugal deformability technique. Patients were studied within 72 hours of the acute ischemic event, and 66 were available for follow-up evaluation approximately 2 months later. Two age- and sex-matched control groups were evaluated: 20 nonvascular neurological inpatients (patient controls) and 45 normal volunteers (normal controls). Compared with normal controls, we found significant acute increases in whole blood viscosity (1,500 sec-1), plasma viscosity, fibrinogen concentration, and zeta sedimentation ratio; the latter two variables were also increased at follow-up. Fibrinogen concentration was significantly associated with zeta sedimentation ratio and plasma viscosity and was increased for patient controls. There was a trend toward normalization of acute abnormalities over the 2-month follow-up period, and patients with more severe strokes tended to have more extensive hemorheological abnormalities. Among patients with severe stroke, fibrinogen concentration was significantly associated with the platelet activation peptide beta-thromboglobulin acutely (r = 0.63, p less than 0.005). We conclude that hemorheological abnormalities in cerebral ischemia are largely nonspecific findings, with the likely exception of patients with severe stroke.     

Rheological and fibrinolytic findings in multiple sclerosis

Blood viscosity indices, fibrinolytic activity and other serum proteins related to haemocoagulation have been studied in 36 patients with multiple sclerosis. The whole blood viscosity was found to be increased in multiple sclerosis. The increase was caused by a decrease in erythrocyte deformability since plasma viscosity and haematocrit were normal. Plasminogen, fibrinogen and alpha 2 antitrypsin levels were found to be lower than normal. Such alterations were not observed in a group of patients with other non-immunological neurological diseases. In the latter group some coagulation indices were even higher than normal. The higher mean age of the pathological controls could explain the observed levels. The abnormalities observed in multiple sclerosis patients are considered to be a consequence of a non-specific activation of the coagulative system in a chronic immunological disease.     

Binswanger病血液流变学及血液成份的观察

本文测定了３５例老年Ｂｉｎｓｗａｎｇｅｒ病患者的部分血液流变学及血液成份的变化。结果发现，与健康对照组和脑动脉硬化组比较，疾病组高切变率全血粘度显著升高，红细胞变形能力明显降低，血液成份ＨＧ、ＭＣＶ、ＭＣＨ、ＭＣＨＣ、ＲＤＷ显著增加。提示红细胞的老化性改变参与了Ｂｉｎｓｗａｎｇｅｒ病的发生，设法提高患者红细胞变形能力和降低血粘度将有益于阻止该病的进展。     

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.     

RBC and plasma choline in neuroleptic-treated schizophrenic patients

We measured red blood cell (RBC) choline and plasma choline concentrations in 27 chronic schizophrenic inpatients and 23 normal controls. Both blood choline measures had a significant test-retest reliability in patients whose neuroleptic status remained unchanged over 1 month. RBC choline concentration was significantly lower in patients medicated with neuroleptics and cogentin. Patients with a low RBC choline and a low RBC/plasma choline ratio were on significantly higher doses of medication and had higher scores on the hostility/suspiciousness subscale of the Brief Psychiatric Rating Scale. RBC choline increased when neuroleptics were discontinued. Blood choline measures were also compared among medication-free schizophrenic patients, inpatients with other diagnoses, and normal controls. No significant differences were seen among these groups for any choline measure, although the schizophrenic patients showed greater variability. Medication-free schizophrenic patients with such clinical factors as tardive dyskinesia and abnormalities on computed tomography contributed to this variability. Age was positively correlated with plasma choline.     

Correlation between testosterone, gonadotropins and prolactin and severity of negative symptoms in male patients with chronic schizophrenia

The aim of this study was to evaluate the relationship between plasma levels of testosterone, FSH, LH and prolactin and the severity of negative symptoms in patients with chronic schizophrenia. Fifty-four male inpatients with chronic schizophrenia participated in this cross-sectional study. Twenty-five age-matched men without a history of psychiatric disorders or endocrine illnesses were used as controls. All patients were on risperidone 4 mg/day or haloperidol 10 mg/day and anticholinegic medication, biperidine 3 mg/day. The patients were assigned to groups with predominant negative and nonpredominant negative symptoms on the basis of their scores on the Positive and Negative Syndrome Scale (PANSS). Plasma levels of testosterone and free testosterone in the patients with predominant and nonpredominant negative symptoms were significantly lower than those in normal controls. Furthermore, plasma levels of FSH and LH, in the patients with predominant negative symptoms but not in the nonpredominant negative symptoms, were significantly lower than those in the normal controls. In contrast, plasma level of prolactin in the predominant negative symptoms group but not in the nonpredominant negative symptoms group was significantly higher than the aged matched normal males. Significant inverse correlation between negative subscale scores of PANSS and plasma levels of testosterone and free testosterone in the patients with predominant negative symptoms were detected. There was also a positive correlation between prolactin plasma levels and negative subscale scores. The present study indicates that assessment of sex hormones and function of hypothalamic-pituitary-gonadotropin axis could be an important biological marker for the severity of negative symptoms in schizophrenia and these findings may change the present pharmacotherapy for negative symptoms based on neuroendocrinology profiles of patients with schizophrenia.     

Hemorheologic parameters in correlation to extracranial carotid artery disease in patients with acute cerebrovascular disorders

In order to determine possible correlations to the extent of extracranial carotid artery disease (ECAD), the hemorheologic parameters (hematocrit, fibrinogen, whole blood and plasma viscosity, induced platelet aggregation) of 120 patients with acute cerebrovascular disorders (CVD) were studied and their carotid arteries were investigated by means of Duplex scanning. Plasma viscosity was only significantly elevated in CVD patients with severe ECAD (stenosis greater than 80% lumen reduction and/or occlusion) in comparison to CVD patients with normal to minimally diseased carotids and 67 normal controls. These results suggest that high plasma viscosity is an indicator for the existence of severe ECAD in CVD patients during the acute stage.     

A biochemical study of tardive dyskinesia in young male patients

Based on specific criteria, tardive dyskinesia was diagnosed in 6 out of 29 young schizophrenic male inpatients. We compared several biochemical parameters in these six dyskinesia patients with those in six matched controls. The patients with dyskinesia had significantly lower platelet monoamine oxidase activity and significantly higher plasma dopamine-beta-hydroxylase activity as compared with the controls, thus confirming our previous findings in a population of elderly female inpatients. The dyskinetic and nondyskinetic groups did not differ from each other in mean whole blood serotonin concentration and mean serum neuroleptic concentration as measured with a radioreceptor binding assay. Possible significance of our results is discussed.