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。     

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。     

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     

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。     

血液流变学昼夜生理节律性的研究

对３６例健康志愿者及３１例有高血压、高脂血症患者的全血经粘度、血浆比粘度、红细胞压积、血浆纤维蛋白原含量及红细胞变形性等血液流变学指标进行了昼夜２４小时的动态监测，取血时点分别为６：００、１２：００、１８：００、２４：００、呼指标测定分别采用毛缰管粘度计法，微管离心沉淀法，双缩脲法及激光衍射法。结果表明除红细胞变形指数外，余各指标均存在一昼夜２４小时的波动性变化，其中全血比粘度，血浆比粘度以及血浆     

高血糖时红细胞聚集与急性脑梗塞关系的研究

目的探讨高血糖时红细胞（ＲＢＣ）聚集在急性脑梗塞（ＣＩ）发病中的作用。方法８７例急性ＣＩ患者依有无糖尿病（ＤＭ）及空腹血糖水平分组检测血液流变学指标。结果ＤＭ组ＥＥＴ显著延长,与高血糖反应组均有ＥＳＲ及其方程Ｋ值显著增高;正常血糖组以全血低切粘度、聚集指数增高为著。结论高血糖时ＣＩ患者红细胞聚集增强,糖尿病伴发ＣＩ患者尤著。ＲＢＣ聚集性增强可能是ＤＭ伴发腔隙性梗塞的原因之一,对高血糖时ＣＩ面积增大及脑水肿的加重有影响。     

52例老年期抑郁症的血液流变学对照分析

目的为了探讨老年期抑郁症的血液流变学变异。方法对５２例女性老年期抑郁症（患者组）和４８例健康老年人（对照组）的血液流变学进行了检测,并对其中１２例患者于治疗后进行了复测。结果患者组在全血比低切粘度、红细胞聚集指数、红细胞压积和还原比粘度等显著高于对照组（Ｐ〈０．０５或Ｐ〈０．０１）。其次,患者组经治疗后血液流变学各项指标较治疗前均有不同程度的降低（Ｐ〉０．０５）。结论老年期抑郁症患者存在着血液变学     

急性脑出血患者的缺血危险因素分析

目的：分析急性脑出血患者的脑缺血相关危险因素,探讨急性脑出血的合理治疗方案。方法：动态观察了54例急性脑出血和75例急性脑梗死患者治疗前后的血液流变学,血浆渗透压,血小板聚集率以及头颅CT的改变。结果：脑出血组和脑死组患者的全血粘度,血浆渗透压,红细胞压积,纤维蛋白原,血小板浓度无明显差异,脑梗死组血小板聚集率明显高于脑出血组（P＜0．05）。31例脑出血患者治疗两周后复查头颅CT,其中有4例患者出现新的脑梗死 灶,此4例患者平均年龄以及纤维蛋白原水平高于脑出血组（P＜0．01）,结论：脑出血和脑死是发生于脑血管病变基础上的两个相关联的病变,二者有许多共同的危险因素,脑出血发生及演变过程中可继发病脑梗死,而该过程中血小板聚集率及纤维蛋白原的增高可能与脑出血继发脑梗死的发生有一定的关系,脑出血治疗过程 应强调沦的脑功能监测,尽量有脑出血急性期后早期改善脑循环并同时给予脑保护治疗。     

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。     

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。     

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.     

Hemorheological effect of ticlopidine in the rat

Hemorheological effect of ticlopidine was studied with rats in various tests including whole blood viscosity, blood filtrability through a micropore membrane, mechanical hemolysis and shear stress-induced red cell deformability which was studied by a new technique developed by us.Ticlopidine treatment (30–300 mg/kg, p.o.) resulted in decrease in viscosity of heparinized whole blood, increase in blood filtrability and red cell stability against mechanical hemolysis. Ticlopidine was also found to increase reversible deformability of the red cells in response to shear stress which was evoked by passing whole blood through a thin tube (0.15 mm Ø) in a high speed (0.1 ml/0.2 sec). However, ticlopidine did not affect hematocrit values, plasma fibrinogen levels and plasma viscosity. Red cell morphology was not affected under the conditions without shear stress.These findings indicate that ticlopidine decreases whole blood viscosity by increasing red cell deformability, and that the effect may be favorable for improvement of microcirculation disorders.     

Hemorheology, stroke and the elderly

Whole blood filterability was measured in 53 stroke patients (28 patients 40-60 yr and 25 patients greater than 60 yr) to study the hemorheologic parameters, stressing the changes occurring in the elderly. A negative linear correlation was found between whole blood filterability and the hematocrit, plasma viscosity and the serum level of macroproteins (alpha 2-globulin, gamma-globulin and fibrinogen), indicating that whole blood filterability is a collective measure of the different hemorheologic parameters. Whole blood filterability was significantly reduced in stroke patients as compared to normal control values. This reduction could not be attributed to a difference in hematocrit or plasma viscosity, which emphasizes the role of red cell deformability in the filterability of blood of stroke patients. Moreover, whole blood filterability was significantly lower in stroke patients more than 60 yr old than in stroke patients less than 60 yr old. Both plasmatic and red cell factors were contributing factors in the reduction of filterability in the elderly.     

不同种类脑梗死的血液流变学特性及药物作用的研究

目的　从血液流变学变化的特点来探讨不同种类脑梗死的发病机制异同,评价东菱克栓酶治疗急性脑梗死的作用机制。方法　对100例健康者和 124 例脑梗死患者行血液流变学检查,并观察东菱克栓酶对不同种类脑梗死患者血液流变学指标和神经功能缺损恢复的作用。结果　脑梗死患者全血黏度、红细胞聚集性和纤维蛋白原均增高,且主干支组高于深穿支组(P <0.05),血小板聚集性也明显增高,但后者高于前者(P <0.05)。东菱克栓酶治疗后纤维蛋白原水平、红细胞聚集性、全血黏度和血小板聚集性较治疗前有显著性下降(P <0.05)。治疗后1周和1月,治疗组中主干支组、深穿支组的神经功能恢复均较对照组中的主干支组、深穿支组好 (P < 0.01)。结论　脑叶大梗死和脑深部小梗死在发病机制上有所不同。东菱克栓酶治疗上述两类急性脑梗死疗效肯定。     

Factors influencing cerebral perfusion and their role in the development of cerebral circulatory disturbances

Factors increasing blood viscosity grow in importance when the blood flow is reduced. Hemorheological parameters determining blood viscosity include hematocrit (Htc), red cells aggregation, red cell deformability, platelet aggregation and plasma viscosity. Platelet abnormalities seem to underlie transient ischemic attacks whereas Htc and plasma viscosity probably play an important role in complete stroke. Present therapeutic methods of stroke base, in large part, on the isovolemic or hypervolemic hemodilution, which lead to reduction of Htc. The problem of optimal value of Htc which should be achieved for improving cerebral blood flow and a sort of the plasma expander has been opened for discussion.     

Blood rheology in deep venous thrombosis--relation to persistent and transient risk factors

INTRODUCTION: The risk of recurrence in patients with symptomatic deep venous thrombosis (DVT) is higher in patients with persistent risk factors than in patients with transient risk factors. The purpose of this prospective study was to investigate the course of rheological variables in patients with DVT up to 1 year after the acute event in relation to risk factors. PATIENTS AND METHODS: In 37 patients with proven DVT plasma fibrinogen, plasma viscosity, red cell aggregation, whole blood viscosity, hematocrit and platelet aggregation were studied in the acute phase, at 6 weeks and at 12 months. RESULTS: In the acute phase, patients had higher fibrinogen (medians and ranges; 450 [270-611] vs. 247 [170-340] mg/dl, p < 0.01), plasma viscosity (1.67 [1.48-1.96] vs. 1.60 [1.50-1.70] mPa s, p < 0.01), red cell aggregation (9.76 [5.87-12.66] vs. 5.66 [3.67-8.46] arbitrary units; p < 0.01) and whole blood viscosity (5.78 [5.61-5.87] vs. 5.59 [5.27-5.9] mPa s, p < 0.01), but lower hematocrit (40 [32-46] vs. 45 [38-50]%, p < 0.01) and platelet aggregation (by epinephrine: 41 [13-85] vs. 79 [29-91]%, (p < 0.01) than controls. During the 1-year follow-up, fibrinogen, plasma viscosity, red cell aggregation and whole blood viscosity constantly decreased, whereas hematocrit and platelet aggregation increased in the total of patients (all p < 0.01). Subgroup analysis according to risk factors showed that at 12 months patients with persistent risk factors (N = 21) had higher plasma fibrinogen (357 [235-450] vs. 247 [214-335] mg/dl, p < 0.01), plasma viscosity (1.65 [1.50-1.80] vs. 1.59 [1.42-1.77] mPa s, p < 0.05) and red cell aggregation (7.82 [6.0-11.3] vs. 6.3 [5.2-7.1] arb. units, p < 0.01) than patients with transient risk factors (N = 16). Compared with controls, these variables were increased in patients with persistent risk factors (all p < 0.01), but not in patients with transient risk factors (all n.s.). CONCLUSION: In patients with persistent risk factors rheological changes are still present 1 year after acute DVT, whereas in patients with transient risk factors blood rheology returns to normal. Further studies are needed to clarify whether blood rheology might be helpful to identify patients at high risk of recurrence.     

A study of erythrocyte deformability using an ektacytometer in normal adults and in patients with acute cerebral infarction

We studied the erythrocytes deformability with an ektacytometer made in China in 55 normal adults and in 22 patients with acute cerebral infarction (ACI). The results showed that sex has no influence upon the deformability of RBC in normal adults. The deformability of RBC decreases with the age, but there is no significant difference between different age groups. The deformability of RBC in ACI decreases obviously. It may be one of the factors that increase the whole blood viscosity in ACI. The measurement of RBC deformability with ektacytometer is simple, fast and only 20u mu whole blood needed. The ektacytometer is a valuable tool in experimental and clinical researches.     

The association of platelet and red cell count with platelet impedance changes in whole blood and light-scattering changes in platelet rich plasma: evidence from the Caerphilly Collaborative Heart Disease Study

This epidemiological study was undertaken to explore possible relationships among various haematological indices, prevalent ischaemic heart disease and platelet "function" as measured by two rather different methods. ADP-induced platelet impedance changes in whole blood were strongly associated with prevalent ischaemic heart disease in a general population of 49-66 year men at increased risk. Adenosine diphosphate (ADP) induced platelet aggregation in platelet rich plasma (PRP) at a constant platelet count and also the whole blood platelet count and red cell (RBC) count were strongly and independently related to ADP-induced platelet impedance changes. Both platelet count and platelet aggregation in PRP assessed by changes in optical density were directly related to increasing platelet "sensitivity" as measured by impedance changes in whole blood but RBC count was inversely related. Positive independent relationships between platelet impedance changes and plasma viscosity and fibrinogen were markedly attenuated when platelet count was taken into account, but this finding does not discount a role for these factors in platelet aggregation. No relationship was noted between white blood cell (WBC) count and platelet impedance changes; however, a significant inverse relationship was noted with platelet aggregation in PRP. These findings indicate that laboratory-based experimental findings can be observed in population based studies, and that these haematological factors may be important indicators of ischaemic disease in the population.     

The effect of physiological levels of fibrinogen on platelet aggregation

Results from the Northwick Park Heart Study (NPHS) suggest that physiological levels of plasma fibrinogen may influence platelet aggregability. This possibility has been further studied by the addition of purified fibrinogen to the blood of 17 study participants with low plasma fibrinogen levels. The results, which were highly consistent between different individuals, showed that fibrinogen increases aggregability as measured by the ADP ED50, the dose of adenosine diphosphate at which aggregation proceeds at half its maximum velocity. However, an increasing plasma fibrinogen level was associated with decreasing aggregability measured by another parameter, the ADP EMR (estimated maximum response). Although the balance of evidence is that the plasma fibrinogen level enhances aggregability, these conflicting results emphasize the limitation of any simple concept of "platelet aggregability".