氯沙坦对老年高血压患者红细胞聚集性的影响

目的 探讨氯沙坦对老年高血压患者红细胞聚集性的影响。方法 43例老年高血压患者服用氯沙坦50－100mg治疗12－17个月后观察治疗前后血液流变学指标的变化。结果 高血压患者全血低切粘度（1Os^-1)、血浆粘度及红细胞聚集指数显著增高（P＜0．05），服用氯沙坦后高血压患者血压下降的同时全血低切粘度、血浆粘度及红细胞聚集显著降低（P＜0．001）。结论 氯沙坦可使老年高血压患者红细胞聚集性显著降低，血粘度下降，血浆粘度下降。从而降低了体内血栓形成的机会，减少心血管系统血栓性疾病的发生率。     

氯沙坦对老年高血压患者红细胞变形性的影响

目的 研究氯沙坦对老年高血压患者红细胞变形性的影响。方法 43例老年高血压患者服用氯沙坦50－100mg，治疗12－17个月后观察治疗前后血液流变学指标的变化。结果 高血压患者全血高切粘度（120S^-1)、血浆粘度及红细胞刚性指数显著增高，服用氯沙坦后高血压患者在血压下降的同时全血高切粘度、血浆粘度及红细胞刚性指数显著降低（P＜0．05）。结论 氯沙坦可使老年高血压病患者红细胞变形性显著增强，血粘度降低，从而改善全身脏器循环灌注，保护心、脑等重要脏器功能，改善预后。     

丹田降脂丸联合氯沙坦对糖尿病肾病蛋白尿疗效观察

目的 观察丹田降脂丸联合氯沙坦对糖尿病肾病患者蛋白尿的影响.方法 将60例2型糖尿病肾病(DN)患者随机分成两组:丹田降脂丸联合氯沙坦组(治疗组)和单独氯沙坦组(对照组),每组30例,给予相应药物治疗6个月,分别观察治疗前后两组24小时尿蛋白定量、总胆固醇(TC)、三酰甘油(TG)和血液流变学的变化.结果 治疗前后治疗组和对照组24小时尿蛋白定量、TC、TG比较差异有统计学意义(P＜0.05);治疗组治疗前后血浆粘度、全血高切还原粘度、全血低切还原粘度、红细胞聚集指数、红细胞变形指数均明显改善(P＜0.05),治疗组治疗后除全血低切还原粘度(P＞0.05)之外,其他各项指标均优于对照组(P＜0.05).结论 丹田降脂丸联合氯沙坦治疗DN能减少尿蛋白,疗效优于单用氯沙坦,且能有效改善血脂代谢异常和血液流变学等作用.     

通脉口服液对系膜增殖性肾炎大鼠血液流变学的影响

目的 :探讨通脉口服液对慢性肾炎血液流变学的影响。方法 :建立大鼠系膜增殖性肾炎模型 ,随机分为通脉高剂量组、通脉低剂量组、金水宝组、病理模型组及正常对照组 ,治疗 4周后 ,眼眶采血 ,对血液流变学指标进行测定。结果 :通脉口服液可以改善系膜增殖性肾炎大鼠全血比粘度 (包括低切及高切 )、聚集指数、血浆比粘度、红细胞压积 (P均 <0 .0 1)及全血还原粘度 (P <0 .0 5 )。结论 :通脉口服液有降低全血比粘度 (包括低切及高切 )、聚集指数、血浆比粘度、红细胞压积 (P均 <0 .0 1)及全血还原粘度 (P <0 .0 5 )的作用 ,可以改善血液流变学。     

糖尿病视网膜病变的血液流变学探讨

对糖尿病视网膜病变（DR）28例，无视网膜病变（NDR）32例进行血液为指标和GHb检测并观察。结果DR组的全血粘度、红细胞压积、血沉（ESR）、血沉方程K值、全血高切还原粘度、全血低切还原粘度、是性指数、红细胞聚集指数明显高于NDR组（P＜0.05）。结论 DR的血液流变学改变较NDR组改变显，与病程呈正相关。     

杞菊地黄汤对原发干燥综合征患者血液流变学的影响

目的 通过检测杞菊地黄汤治疗原发干燥综合征(pSS)前后血液流变的变化,探讨该药对患者血液流变学的影响.方法 给30例pSS患者治疗前后临床疗效评分,检测治疗前后血液流变学的各项指标,并分析其相关性.结果治疗后眼干症状、口干症状、泪流率、唾液流率各临床评分例数较治疗前减少(P<0.05),外周血血液全血黏度(低切、高切)、血浆黏度、全血还原黏度(低切、高切)、红细胞沉降率(ESR)、血细胞沉降率方程K值、红细胞最大聚集指数、变形指数均明显低于治疗前,变形指数明显高于治疗后(P<0.01),并且临床疗效总评分与血浆黏度、血细胞沉降率方程K值、红细胞最大聚集指数呈正相关(r分别为0.874、0.644、0.739,P<0.01),与红细胞最大变形指数呈负相关(r=-0.791,P<0.01).结论 杞菊地黄汤治疗pSS可导致患者有明显的血液流变学改变.     

氯沙坦对老年高血压患者血液流变学和肾结构的影响

目的 观察氯沙坦对老年高血压患者血液流变学、肾血流及肾结构的影响.方法 老年高血压患者63例,观察组43例,服用氯沙坦50～100 mg/d;对照组(复方降压片组)20例,疗程12～17月,分别测定治疗前后血液流变学指标、肾血流及肾血管管壁厚度、内径.结果 氯沙坦治疗后患者血液流变学指标有不同程度的下降,肾血流改善、肾动脉管壁厚度明显变薄(P＜0.01),动脉内径增大(P＜0.05).结论 氯沙坦在有效降压的同时,可有效地降低老年高血压患者的血液黏度,降低肾动脉血管阻力,增加肾血流量,改善肾血管结构.     

丹红注射液对老年高血压血液流变学的影响

目的观察丹红注射液对老年高血压患者血液流变学的影响。方法选择老年高血压患者140例,分成丹红注射液治疗组(72例)和对照组(68例)。治疗组加用丹红注射液30ml加入5%葡萄糖或0.9%氯化钠溶液中静脉滴注,1次/d,疗程12d。对照组不加用丹红注射液,未采取其他干预施。检测两组治疗前后血液流变学指标进行对照分析。结果治疗前后两组的血液流变学指标均有明显改善,差异有统计学意义(P0.01)。治疗后,丹红注射液治疗组全血黏度、血浆黏度、全血还原黏度、血细胞比容、红细胞聚集指数、红细胞刚性指数、红细胞变形指数以及红细胞电泳指数均优于对照组,差异有统计学意义(P0.05)。结论丹红注射液能显著改善高血压患者血液流变学状态,改善微循环,降低血液黏滞度。     

mPCNL灌注液吸收对患者血生化及血液流变学的影响

目的 探讨微通道经皮肾镜取石术(mPCNL)灌注液吸收对机体血生化及血液流变学等指标的影响,为临床及时采取应对措施提供理论依据.方法 对68例上尿路结石患者实施mPCNL.灌注前(T1)、灌注60 min(T2)和灌注毕(T3)分别检测血电解质、血肌酐、血尿素氮、pH、HCO-3浓度及血液流变学指标的水平.结果 68例手术均顺利完成.灌注液量10.80～ 52.5(23.16±10.79)L,未出现灌注液吸收综合征.血Ca2+浓度T2及T3较T1降低(P＜0.05),血CI-浓度T3较T1增高(P＜0.05).pH及HCO-2浓度T2、T3较T1降低(P＜0.05).全血高切黏度、全血中切黏度、全血低切黏度、全血高切还原黏度、全血低切还原黏度、血浆黏度、红细胞变形指数、最大血小板聚集率、红细胞聚集指数T3、T2较T1具有统计学差异(P＜0.05),红细胞压积、红细胞刚性指数T2较T1具有统计学差异(P＜0.05),全血高切黏度、血浆黏度、红细胞压积、红细胞刚性指数、最大血小板聚集率T3较T2具有统计学差异(P＜0.05).结论 mPCNL术中存在着一定量的灌注液吸收,手术时间过长、灌注液量较多时应加强对血生化及血液流变学指标的监测,并及时做出针对性处理.     

阿托伐他汀钙片联合低分子肝素钙对脑梗死患者血脂和血液流变学的影响

目的 探讨阿托伐他汀钙片联合低分子肝素钙对脑梗死患者血脂和血液流变学的影响.方法 选取2010年10月-2012年10月我院收治的急性脑梗死患者236例,将其随机分为对照组和治疗组,各118例.对照组皮下注射低分子肝素钙,治疗组在对照组基础上给予阿托伐他汀钙片口服治疗.观察两组疗效,并进行血脂（TC、TG、LDL-C、HDL-C）、血液流变学（全血高切黏度、全血低切黏度、血浆黏度、全血还原黏度、纤维蛋白原、红细胞聚集指数、红细胞刚性指数、红细胞内黏度、血细胞比容）等检测.结果 治疗前两组TC、TG、LDL-C、HDL-C比较,差异无统计学意义（P＞0.05）;治疗后治疗组TC、TG、LDL-C低于对照组,HDL-C高于对照组（P＜0.05）.治疗前两组全血高切黏度、全血低切黏度、血浆黏度、全血还原黏度、纤维蛋白原、红细胞聚集指数、红细胞刚性指数、红细胞内黏度、血细胞比容比较,差异均无统计学意义（P＞0.05）;治疗后治疗组全血高切黏度、全血低切黏度、全血还原黏度、纤维蛋白原、红细胞聚集指数、红细胞刚性指数、红细胞内黏度均低于对照组（P＜0.05）.治疗组总有效率为92.4％ （110/118）,高于对照组的69.5％ （82/118） （P＜0.05）.结论 阿托伐他汀钙片联合低分子肝素钙对脑梗死患者血脂和血液流变学的干预疗效显著,降脂效果明显,可降低脑血管疾病的发生,改善脑梗死预后,临床效果显著,值得广泛推广.     

冠心病患者治疗前后促红细胞生成素和血液流变学的动态变化及对血黏度的影响

目的观察促红细胞生成素(EPO)、血常规、血液流变学参数在冠心病患者PCI前后24 h的动态变化及对血黏度的影响。方法选择冠心病患者117例,分为急性心肌梗死组(心梗组)45例,不稳定性心绞痛组(不稳定组)50例,稳定性心绞痛组(稳定组)22例;另选取健康体检者40例为对照组。对患者入院、PCI后24 h的EPO、血常规和血液流变学进行对比分析,并进行Pearson相关分析。结果与治疗前比较,心梗组、不稳定组、稳定组患者治疗后FPO、红细胞聚集指数、红细胞压积明显下降,血红蛋白、血小板、全血黏度低切明显升高(P<0.05,P<0.01);Pearson相关分析显示,冠心病患者治疗前和治疗后EPO与红细胞聚集指数、红细胞压积呈正相关,与血红蛋白、全血黏度低切、血小板呈负相关(P<0.05,P<0.01)。结论内源性EPO可能通过红细胞聚集指数、红细胞压积、血红蛋白、血小板、全血黏度低切间接影响冠心病患者的血黏度,且治疗前和治疗后冠心病患者均处于高血黏度状态。     

Haemorheological effects of losartan and enalapril in patients with renal parenchymal disease and hypertension

The objective of this study was to compare the effects of the angiotensin II (ang II) antagonist, losartan and the angiotensin-converting enzyme inhibitor (ACEI), enalapril on haemorheology. Twenty-nine patients with renal parenchymal disease and hypertension were enrolled in the prospective, open, parallel study that involved a 14-day washout period followed by a 120-day treatment period. Patients were allocated randomly to receive either losartan 50-100 mg/day (n = 15) or enalapril 2.5-10 mg/day (n = 14) to achieve blood pressure control <140/90 mm Hg. Blood pressure, haemorheology profile and plasma fibrinogen concentration were measured after the washout phase and after 2, 10, 60, and 120 days of treatment. The data were analysed using ANOVA with repeated measures. Twenty-seven patients completed the study. Treatment with both losartan and enalapril was associated with a significant decrease (P < 0.05) in relative high shear rate whole blood viscosity, indicating an increase in blood cell deformability. In patients taking losartan, the increase in blood cell deformability did not result in a decrease in mean whole blood viscosity due to a concomitant, significant increase in mean plasma viscosity (P < 0. 01). In contrast, the improved cell deformability in patients treated with enalapril resulted in a small and statistically insignificant decrease in mean whole blood viscosity (P = 0.06; mean change = -0.15 mPa sec). The mechanism of the increase in blood cell deformability and the rise in plasma viscosity associated with losartan remain unclear. It is possible but unproven that the improvement in intrinsic blood cell rheology with losartan and enalapril may be the result of changes in cation transport systems and/or the consequence of the protective antioxidant properties of drug metabolites.     

氯沙坦联用葛根素对原发性高血压左心室肥厚的逆转及胰岛素抵抗的影响

目的观察氯沙坦单用或联用葛根素对原发性高血压并左室肥厚(LVH)的逆转作用及其对胰岛素抵抗的影响.方法 60例原发性高血压并左室肥厚病人随机分成两组:对照组(A组)30例口服氯沙坦,每日50 mg;治疗组(B组)30例给予氯沙坦,每日50 mg,加葛根素注射液500 mg.两组均持续治疗4周.观察左室形态结构和左室功能变化及其对胰岛素抵抗的影响.结果两组治疗后,血压水平降低,室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室舒张末期内径(LVDd)、左室重量(LVMI)均显著下降(P<0.05或P<0.01),特别是B组在逆转LVH方面效果优佳(P<0.05).与A组比较,B组治疗后2 h血糖和空腹胰岛素明显降低,而胰岛素敏感性指数明显升高.结论氯沙坦联用葛根素治疗原发性高血压,既可有效降压,又可逆转LVH以及改善胰岛素抵抗.     

Haemorrheological abnormalities in unstable angina pectoris: a relation independent of risk factor profile and angiographic severity

Plasma viscosity, photometric erythrocyte aggregation index, and erythrocyte filterability were measured in 194 patients with coronary artery disease. Patients with unstable angina (n = 64) had a higher plasma viscosity and photometric erythrocyte aggregation index than patients with stable angina (95% confidence intervals for the mean difference: 0.052-0.100 mPa.s for plasma viscosity, and 43%-72% for the photometric erythrocyte aggregation index). Multiple regression with fibrinogen, cholesterol, high density lipoprotein cholesterol, triglycerides, blood pressure, smoking habits, coronary artery score, and left ventricular ejection fraction as independent variables showed a significant partial correlation between fibrinogen and the photometric erythrocyte aggregation index (r2 = 0.20) and plasma viscosity (r2 = 0.09), between triglycerides and plasma viscosity (r2 = 0.05), and between aortic pressure and erythrocyte filterability (r2 = 0.03). Logistic regression for unstable/stable angina with the haemorrheological variables as independent variables correctly identified 72% of the patients with stable angina and 78% of those with unstable angina. Inclusion of all the variables investigated did not substantially improve the discriminative potential of the logistic regression model. Unstable angina is associated with an impairment of blood fluidity that is essentially independent of risk factor profile and angiographic data.     

Haemorrheological abnormalities in unstable angina pectoris: a relation independent of risk factor profile and angiographic severity.

Plasma viscosity, photometric erythrocyte aggregation index, and erythrocyte filterability were measured in 194 patients with coronary artery disease. Patients with unstable angina (n = 64) had a higher plasma viscosity and photometric erythrocyte aggregation index than patients with stable angina (95% confidence intervals for the mean difference: 0.052-0.100 mPa.s for plasma viscosity, and 43%-72% for the photometric erythrocyte aggregation index). Multiple regression with fibrinogen, cholesterol, high density lipoprotein cholesterol, triglycerides, blood pressure, smoking habits, coronary artery score, and left ventricular ejection fraction as independent variables showed a significant partial correlation between fibrinogen and the photometric erythrocyte aggregation index (r2 = 0.20) and plasma viscosity (r2 = 0.09), between triglycerides and plasma viscosity (r2 = 0.05), and between aortic pressure and erythrocyte filterability (r2 = 0.03). Logistic regression for unstable/stable angina with the haemorrheological variables as independent variables correctly identified 72% of the patients with stable angina and 78% of those with unstable angina. Inclusion of all the variables investigated did not substantially improve the discriminative potential of the logistic regression model. Unstable angina is associated with an impairment of blood fluidity that is essentially independent of risk factor profile and angiographic data.     

青紫型先天性心脏病红细胞膜流动性及血液流变学

为探讨青紫型先天性心脏病红细胞膜性能的改变及其临床意义，应用荧光偏振法测定了３１例患儿红细胞膜微粘度及血液流变学指标。结果：患儿红细胞膜微粘度及全血粘度、血细胞比容、红细胞聚集指数、刚性指数均显著高于正常组（３０例）（Ｐ＜０．０１）；膜微粘度与全血粘度、红细胞刚性指数呈明显正相关（Ｐ＜０．０１）。研究表明，青紫型先天性心脏病红细胞膜微粘度增高，流动性降低，可能是引起红细胞变形性差，血液粘度增加较为重要的原因之一。     

参麦注射液对老年肺心病心功能及血液流变学的影响

目的：观察参麦注射液对老年肺心病急性加重期患心功能及血液流变学影响。方法：78例慢性肺心病急性加重期伴有心功能不全患随机被分为2组，其中40例为观察组，在常规治疗的基础上加用参麦注射液治疗，连续2周；对照组38例仅予常规治疗，治疗前、后以多普勒超声心动图评定心功能，并进行血液流变学检测。结果：观察组患经参麦注射液治疗后心排量、心脏指数、射血分数均显增加(P＜0．01)。同时血液流变学示全血粘度、血浆比粘度、红细胞聚集指数、红细胞电泳时间、红细胞比积、血小板聚集率、纤维蛋白原定量均显下降(P＜0．01或P＜0．05)，其心功能与血液流变学的改善均明显忧于对照组(P＜0．05)。观察组临床总有效率及显效率分别为90．0％及50．0％；明显高于对照组的71.1％及26．3％(P＜0．05)。治疗期间未见明显副作用。结论：参麦注射液能显改善肺心病急性加重期患的心功能及血液流变性，是治疗肺心病的一种有效而安全的药物。     

持续气道正压通气治疗对OSAHS患者血液流变学的影响

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者经鼻持续气道正压通气(ncpap)治疗对其血液流变学指标的影响。方法随机选择我科确诊为中度或重度OSAHS的患者30例,其中男20例,女10例,年龄45~68岁,平均年龄(58±3)岁,治疗前14d内未服用过非甾体类消炎药及阿斯匹林,潘生丁等抗凝剂,并排除其它呼吸系疾病、紫绀性先心病、肾脏疾病及原发性红细胞增多症,分别于治疗前及治疗30d后检测血细胞比容、全血比粘度(高切度、中切度、低切度),红细胞聚集指数。结果治疗后血细胞比容、全血比粘度(高切度、中切度、低切度)、红细胞聚集指数较治疗前显著降低(P<0.01)。结论OSAHS存在显著血栓栓塞高危因素,ncpap对其有明显防治作用。     

Improvement of hemorheological abnormalities in alcoholics by an oral antioxidant

BACKGROUND/AIMS: It has been shown that alcohol impairs erythrocyte (red blood cell) membrane fluidity and lipid composition. The aim of this study was to test the effect of a novel acid-resistant antioxidant on the hemorrheology in alcoholics. METHODOLOGY: Thirty alcoholics (25 males, 5 females; mean age: 42 years; range: 31-54; 150 g ethanol/day for 3-5 years) were enrolled into the study. Patients were randomly and double-blindly allocated into 2 groups which were given, for a 2 week period, 18 g/day of Bionormalizer (obtained from biofermentation of carica papaya, pennisetum purpureum, sechium edule, Osato Res. Foundation, Gifu, Japan) dissolved in 5 mL of water at bedtime and 3 hours prior to examination. Placebo consisted of flavored sugar. Healthy teetotalers served as control. On the examination day, blood samples were taken for testing: routine tests, plasma glutathione, ascorbic acid, selenium, plasma lipid hydroperoxides and alpha-tocopherol. Erythrocytes were separated and tested for red blood cell malonyldialdehyde and glutathione content. The hemorheological studies were as follows: blood and plasma viscosity, whole blood filterability, red blood cell membrane fluidity by electron spin resonance, red blood cell aggregation index by photometric rheoscopy and red blood cell deformability by ektacytometry. RESULTS: As compared to healthy controls, alcoholics on placebo treatment showed no change of plasma viscosity but a significantly higher red blood cell malonyldialdehyde, blood viscosity (P < 0.05) and lower plasma glutathione, whole blood filterability and red blood cell fluidity (P < 0.01). No relationship appeared between biochemical tests and red blood cell membrane fluidity. Bionormalizer group showed a significant recovery to control values of either blood viscosity and whole blood filterability (P < 0.01) and a partial, although significant, improvement of red blood cell membrane fluidity, red blood cell malonyldialdehyde and plasma glutathione (P < 0.05). As compared to healthy control, red blood cell aggregation decreased in alcoholics (P < 0.05) and was not affected by Bionormalizer. However, Bionormalizer significantly improved the reduced red blood cell deformability (P < 0.05 vs. alcoholics) and this parameter correlated with red blood cell malonyldialdehyde (r: 0.62. P < 0.05). CONCLUSIONS: These preliminary data suggest that an effective antioxidant supplementation is able to improve the hemorrheology in alcoholics either by directly affecting the ethanol-related lipoperoxidation and xanthine oxidase system activation and/or by modifying red blood cell membrane characteristics.     

Changes of hemorrheology in COPD patients with or without cor pulmonale

Parameters of hemorrheology such as whole blood viscosity, plasma viscosity, hematocrit and red blood cell electrophoretic time were measured in 34 COPD patients with or without cor pulmonale, and the pulmonary arterial pressure was simultaneously examined. The results showed that the whole blood viscosity and hematocrit in cor pulmonale group were obviously higher than COPD group which suggested the changes of hemorrheology was much obvious in patients with cor pulmonale than those in COPD patients. Meanwhile, a statistically significant correlation was obtained between whole blood viscosity and pulmonary arterial mean pressure. Thus, we suggest blood viscosity has a certain effect on the pulmonary arterial pressure.