前部缺血性视神经病变血液流变学分析

目的观察前部缺血性视神经病变的血液流变学改变,探讨其发生因素,为治疗和预防提供客观依据。方法前部缺血性视神经病变视乳头水肿期患者３９例（男１９例,女２０例）与相同例数的可以与之相匹配的正常对照组男、女各２０例进行血液流变学检查及统计学处理。结果患者组明显高于对照组（Ｐ＜０．０１,Ｐ＜０．０５）的项目有：红细胞压积、纤维蛋白原、低切粘度、聚集指数、红细胞电泳时间。女性患者高切粘度和血浆粘度亦显著高于对照组（Ｐ＜０．０１）。结论高血粘度与非颞动脉炎性前部缺血性视神经病变的发生密切相关     

视网膜静脉阻塞的血液流变学分析

目的：观察视网膜静脉阻塞的血液流变学改变,探讨其发生因素,为治疗和预防提供客观依据。方法：视膜静脉阻塞患者５２例（男２２例,女３０例）与相同例数的可以与之相匹配的正常对照组（男２２例,女３０例）进行血液流变学检查及统计学处理。结果：病变组明显高于对照组（Ｐ〈０．０１,Ｐ〈０．０５）的项目有全血高切粘度、红细胞压积、红细胞变形指数。女性患者还有血浆高切粘度明显高于对照组（Ｐ〈０．０５）。结论：高血粘     

载脂蛋白E基因变异与视网膜色素变性关系的研究

目的通过检测中国汉族人视网膜色素变性患者的载脂蛋白Ｅ表型，探讨其基因变异与视网膜色素变性发病的关系。方法采用等电聚焦及免疫印迹方法检测正常人和视网膜色素变性患者的ａｏｐＥ表型。结果视网膜色素变性患者中ε４基因频率明显上升（χ２＝１２．９８３，Ｐ＜０．０１），ε２，ε３基因频率与正常对照组无差异。ａｏｐＥ　ε４等位基因与视网膜色素变性的发病有关联（ＲＲ＝２５．０７１，Ｐ＜０．０１）。结论ａｏｐＥ　ε４基因可能是视网膜色素变性发病的又一遗传因素。     

川芎嗪对原发性开角型青光眼患者的治疗作用

目的 探讨中药川芎嗪对原发性开角型青光眼的血液流变学、眼底荧光血管造影以及视功能的影响。方法 采有自身对照的方法对眼压已控制的原发性开角型青光眼患者１１例（１９）眼进行川芎嗪治疗前后血液流变学测定、眼底蓉光血管造影、Ｈrmphrey视野检查以及图形视诱发电位（ＰＶＥＰ）检测。结果 用磷酸川芎嗪治疗后患者血液流变学各指标明显下降（Ｐ＜０．０５～０．００１）;眼底荧光血管造影臂－脉络膜循环时间从隧的１４．６     

视网膜色素变性的彩色超声多普勒应用

通过彩色超声多普勒成像定量检测视网膜色素变性患者的血流动力学改变,用彩色超声多普勒诊断仪对１７例视网膜色素变性患者进行检测,测定双侧眼动脉、视网膜中央动脉、睫状后动脉的血流参数,对所测得数值用ｔ检验做统计学处理分析。结果：视网膜色素变性患者的血流改变与眼别无关,右、左眼对比无显著性差异（Ｐ＞０．０５）,双侧眼动脉血流正常（Ｐ＞０．０５）,双侧视网膜中央动脉及睫状后动脉血流速度较正常人显著减慢（Ｐ＜０．００１）。结论：彩色超声多普勒检查为视网膜色素变性患者的血流改变提供了量化指标     

原发性视网膜色素变性的血液流变学改变及临床意义

本文对44例视网膜色素变性患者进行了血液流变学检查,与40例健康人进行对照。发现全血粘度与红细胞聚集指数明显高于正常人。作者认为,这种变化可导致全身、局部血液循环障碍,导致组织器官的缺血、乏氧,乃致引起一系列的病理改变,更加重了视网膜功能损害,从而作者提出了用降低血液粘度,降低胆固醇、血脂和增强血液流变性的一些药物来对视网膜色素变性患者进行治疗。     

中药治疗视网膜静脉阻塞的临床研究

采用辨病与辩证相结合，分期与分型相结合的方法，用中药治疗视网膜静脉阻塞４６例。结果：视力提高４．５±０．２５（Ｐ＜０．０１），眼度出血吸收率８７．０％（Ｐ＜０．０５），荧光眼底血管造影渗漏减轻７８．３％（（Ｐ＜０．０１），视野缺损改善３４．８％（Ｐ＜０．０５），总有效率８０．４％。以上观察指标均明显优于对照组（Ｐ＜０．０５～０．０１），患者治疗前后各项血液流变学指标比较有显著差异（Ｐ＜０．０１～０．００１），中药治疗可调节患者血液流变性，起标本兼治作用，且无全身不良反应及副作用。     

慢性青光眼的血液流变学及其影响因素

目的 探索血液流变学对慢性青光眼的影响因素。方法 对４７例慢性青光眼和５４例正常人进行血液流变学检查，应用计算机做多因素ｌｏｇｉｓｔｉｃ回归分析。结果 慢性青光眼患者血液流变学红细胞压积等１１个指标均比正常人组增高（Ｐ〈０．００５）；多因素ｌｏｇｉｓｔｉｃ回归分析，筛选出影响青光眼的３个显著因素。结论 慢性青光眼患者具有高粘滞血症，引起高粘滞血症的主要因素可能是全血还原粘度、血小板粘除率和全血粘度     

老年盘变患者的血液流变学改变

目的：观察老年盘变患者的血液流变学改变。 方法采用ＬＢＹ－Ｎ６型血液粘度计检测２０例老年盘变患者和１０例正常人的３项主要血液流变学指标。 结果全血低切粘度和血浆高切粘度在研究组与对照组之间及研究组的不同年龄组之间均存在显著性差异，干、湿性老年盘变患者之间的３项指标均无显著性差异。 结论基于血液流变学对微循环及组织营养代谢的影响及老年盘变的病理特点，推测血液流变学改变可能是诱发老年盘变的因素之一。     

原发性视网膜色素变性患者体内血液组分的异常变化特点

目的　了解原发性视网膜色素变性（ｒｅｔｉｎｉｔｉｓｐｉｇｍｅｎｔｏｓａ,ＲＰ）患者体内各血液组分的变化情况,为探寻其发病机理和防治提供参考。方法　采用回顾性序列病例研究方法,纳入临床确诊为原发性ＲＰ患者１１９例,正常人对照组１５０例,按盲法由专业技术人员完成血液样本的血常规检查,并分别行ＲＰ组和正常组比较。结果　在ＲＰ患者体内,单核细胞、中性粒细胞、嗜碱性粒细胞百分比分别为（６．５４±１．９４）％、（５５．８９±９．０２％）％、（０．３０±０．４０）％,单核细胞计数、血红蛋白、平均红细胞体积、平均血红蛋白量、红细胞体积分布宽度、平均血小板宽度分别为（０．４２±０．１６）×１０９Ｌ－１、（１４４．２９±１６．４６）ｇ?Ｌ－１、（８８．２３±５．２１）ｆＬ、（３０．３０±２．００）ｐｇ、（１２．８０±０．８０）％、（１２．５±４．９）ｆＬ,均较正常组明显降低（均为Ｐ＜０．０５）;淋巴细胞百分比、淋巴细胞计数、嗜酸性粒细胞计数、嗜碱性粒细胞计数、红细胞计数、血小板计数、平均血小板体积、血小板比积分别为（３４．０９±８．１８）％、（２．２０±０．６１）×１０９Ｌ－１、（０．１０±０．０９）×１０９ Ｌ－１、（０．０１±０．０２）×１０９ Ｌ－１、（４．８２±０．４６）×１０１２Ｌ－１、（２２８．２０±５１．１３）×１０９Ｌ－１、（１０．３０±１．２６）ｆＬ、０．２３±０．０５,均较正常组明显升高（均为Ｐ＜０．０５）。余下的参数与对照组相比,差异均无统计学意义（均为Ｐ＞０．０５）。结论　ＲＰ患者体内血液各组分存在异常变化,提示其发病机理可能与血液成分动态变化有关。     

开角型青光眼血液流变学与眼底荧光血管造影相关关系的研究

观察原发性开角型青光眼患者血液粘度与眼底荧光血管造影充盈时间之间的关系。测量了眼压已控制的原发性开角型青光眼５０例５０只眼高（１２５Ｓ＾－１）、中（２３Ｓ＾－１）和低（１．２４３５Ｓ＾－１）切变率下全血表观粘度，测量了血浆粘度和红细胞压积，进行了眼底荧光血管造影。将四枝视网膜中央动脉完全充盈的时间定为臂一视网膜中央动脉充盈时间。高、中切变率下全血表观粘度、红细胞压积均与臂－－视网膜中央动脉充盈时间     

Blood and plasma viscosity measurements in patients with glaucoma.

Blood viscosity at 10 shear rates, plasma viscosity, packed cell volume, plasma fibrinogen, serum alpha 2-macroglobulin, and serum proteins were measured in 83 patients with low-tension glaucoma (LTG) and 23 patients with 'high-tension glaucoma' (HTG: at least one IOP reading above 40 mmHg) and compared with those in 50 controls. Blood and plasma viscosity values and packed cell volume were significantly higher in the LTG group than those in controls. The HTG and the LTG groups differed only in plasma viscosity, but smoking and drinking habits in the HTG patients were greatly different from those in LTG patients and controls, thus preventing interpretation of data in the HTG group. Within the LTG group viscosity values were highest in a subgroup designated earlier by us as focal ischaemic LTG, whereas another subgroup, senile sclerotic LTG, did not show significant differences compared with controls. These findings may indicate a factor in the pathogenesis of visual field defects and disc cupping in some patients with LTG.     

Blood viscosity in primary open-angle glaucoma

To determine whether hemorrheologic factors play a part in optic nerve cupping and visual field loss in glaucoma, blood viscosity was measured at three shear rates in 27 patients with primary open-angle glaucoma and 18 healthy control subjects matched for sex, mean arterial blood pressure and smoking habits. The study was conducted between 1984 and 1986. The mean viscosity was significantly higher in the glaucoma group than in the control group at all three shear rates. The possible relevance of raised blood viscosity as a causal factor in optic nerve cupping in patients with glaucoma is discussed.     

Increase of erythrocyte aggregation in retinal vein occlusion

Erythrocyte aggregation is one of the principal determinants of blood viscosity at low shear rates (low flow). Anatomical and hemodynamical characteristics make retinal venous circulation particularly dependent on hemorheological factors. Erythrocyte aggregation and other laboratory parameters (haematocrit, fibrinogen, plasma proteins, clotting) were measured in 85 patients presenting with retinal vein occlusion and 64 controls matched for age, sex and vascular risk factors (hypertension, diabetes, smoking). Statistical analysis of the results demonstrated a significant difference between the retinal vein occlusion group an the control group for erythrocyte aggregation (p less than 0.001 for the aggregation index at 10 sec and for the threshold of dissociation). The fibrinogen level, haematocrit and plasma proteins (albumin, IgA, IgG, IgM, total proteins, 2-macroglobulin) were similar in the two groups. No statistically significant difference for erythrocyte aggregation was observed between occlusions of the venous branch and occlusions of the central retinal vein or between ischaemic and non-ischaemic forms. These results suggest that raised erythrocyte aggregation mainly explains the increase in blood viscosity previously demonstrated, and could play a role in the constitution of retinal vein occlusion.     

視網膜中央静脈阻塞與球后血流動力學及血液流變學相關性研究

目的探討視網膜中央静脈阻塞(CRVO)患者的視網膜中央動脈(CRA),眼動脈(OA)的血液動力學、血液流變學改變及其相互關系.方法采用美國AcusoN-128XP/10彩色多普勒成像(CDI)技術檢測23例CRCO患者和23例正常人CRA.OA血液動力學及血液流變學改變.結果 CRVO患者CRA收縮期最大血流速度(Vmax)比對側眼(P＜0.05)及對照眼(P＜0.01)下降,舒張末期最小血流速度(Vmin)比對側眼及對照組顯著性增高(P＜0.05),阻力指數(RI)比對側眼(P＜0.05)及對照組(P＜0.01)增高.低切率全血比粘度較對照組顯著性增高(P＜0.01),并與CRAO患者Vmax(r=-0.641 P＜0.01)、Vmin(r=-0.538 P＜0.01)成負相關.結論 CRVO患眼CRA的CDI參數异常,表明動脈血流速度的下降與CRVO發病相關,CRA供血减少是引起視網膜損害的主要原因之一.低切率全血比粘度增高是導致CRVO患眼CRA血流下降因素之一.     

Haemorheological parameters in patients with retinal artery occlusion and anterior ischaemic optic neuropathy.

The haemorheological parameters haematocrit (Hct), plasma viscosity (PV), red cell aggregation (RCA), red cell filterability (RCF), apparent whole blood viscosity (WBV), and fibrinogen were measured in 31 patients with retinal artery occlusion (RAO), 25 patients with anterior ischaemic optic neuropathy (AION), and 19 patients with giant cell arteritis (GCA). The patient groups were compared with controls of same age and similar prevalence of cardiovascular risk factors. Patients with RAO and AION have a significantly decreased RCF in comparison with controls. All other parameters showed no differences. Patients with GCA had significantly decreased Hct and RCF and increased PV and fibrinogen. After 2 weeks of systemic treatment with high dose steroids in patients with GCA the plasma viscosity had returned to normal and was even lower than in controls, and the Hct and fibrinogen had reached normal levels.     

原发性开角型青光眼眼底荧光血管造影与血液粘度及其它因素的关系

探讨原发性开角型青光眼眼底荧光血管造影与血液粘度及其它因素的关系。方法将１２２只原发性开角型青光眼的眼底荧光血管造影（ｆｕｎｄｕｓｆｌｕｏｒｅｓｃｅｉｎａｎｇｉｏｇｒａｐｈｙ，ＦＦＡ）的臂－脉络膜充盈时间〔ａｒｍ－ｃｈｏｒｏｉｄｆｉｌｌｉｎｇｔｉｍｅ，Ａ－ＣＴ）、臂－视网膜动脉充盈时间（ａｒｍ－ｒｅｔｉｎａｌａｒｔｅｒｙｆｉｌｌｉｎｇｔｉｍｅ，Ａ－ＡＴ）和视网膜动－静脉充盈时间（ｒｅｔｉｎａｌａｒｔｅｒｙ－ｖｅｎｏｕｓｆｉｌｌｉｎｇｔｉｍｅ，Ａ－ＶＴ）与高、中和低切变率下全血表观粘度、血浆粘度及红细胞压积进行逐步回归分析，将７０只眼ＦＦＡ的Ａ－ＡＴ、Ａ－ＶＴ与收缩压、舒张压、年龄和低切变率下全血表现粘度进行逐步回归分析。结果低切变率下全血表观粘度可明显影响Ａ－ＣＴ和Ａ－ＡＴ，而红细胞压积可明显影响Ａ－ＶＴ。低切变率下全血表现粘度和年龄均可影响Ａ－ＡＴ和Ａ－ＶＴ，尤以低切变率下全血表观粘度影响为大。结论血液粘度可明显影响原发性开角型青光眼ＦＦＡ各循环时间。     

Blood viscosity in ocular hypertension

Blood viscosity and its determinants were measured in 27 patients with primary open-angle glaucoma, 15 patients with ocular hypertension and 18 healthy control subjects matched for sex, blood pressure and smoking habits. The mean blood viscosity value was significantly higher in the glaucoma group than in the two other groups at all three shear rates studied; there was no difference in viscosity between the hypertension group and the control group. The mean hematocrit value was significantly lower in the hypertension group than in the two other groups. The results suggest that blood viscosity may contribute to nerve damage in patients with primary open-angle glaucoma. The low hematocrit observed in the patients with ocular hypertension may, by contributing to low viscosity, in some measure protect this group from optic nerve damage.     

灯盏生脉胶囊对缺血性视神经病变的疗效

目的探讨灯盏生脉胶囊对气虚血瘀型非动脉炎性前部缺血性视神经病变（NAION）的临床疗效。方法随机对照试验。将120例NAION患者分为对照组和治疗组,对照组60例（84眼）,治疗组60例（85眼）。对照组给予复方樟柳碱注射液颞浅动脉旁注射,2 ml/次,1次/d。治疗组患者在上述治疗的基础上,加用灯盏生脉胶囊（口服,0.36 g/次,3次/d）进行治疗。治疗3个月后,观察并分析2组患者的总体疗效、视力、视野平均光敏感度以及血液流变学指标的改善情况。采用Wilcoxon 秩和检验、独立样本t检验、配对t检验进行数据分析。结果最终对照组和治疗组分别有49例（70眼）和51例（72眼）完成研究。治疗后,和对照组比较,治疗组患者视力（t=-5.223,P＜0.05）、视野平均敏感度（t=-3.690,P<0.05）较高;治疗组患者的血浆黏度、全血高切黏度、低切黏度、红细胞压积指数及血浆纤维蛋白原水平均较对照组低（t=1.224、3.114、7.458、9.153、2.105,P＜0.05）。治疗组患者视神经病变的总有效率为88%,显著高于对照组（71%）（Z=2.890,P＜0.01）。结论复方樟柳碱注射液联合灯盏生脉胶囊可显著改善NAION患者的视力、视野及血液流变学指标。