冠心病患者血细胞内钙含量对血黏度的影响

目的研究血小板和红细胞内Ca2+含量与冠心病发病关系,探讨Ca2+含量增多引起冠心病发病机制。方法提取外周血中血小板和红细胞,采用流式细胞仪一次性检测细胞中Ca2+含量。结果冠心病组红细胞和血小板中Ca2+指数〔(1413·33±267),(1639·45±356)〕显著高于健康组〔(1123·21±213),(1202·33±302)〕(P<0·05)。在不同切变率条件下冠心病组血液黏度(7·23、7·86、7·88、6·69)高于健康组(5·01、6·93、6·64、6·34、5·76)(P<0·01)。结论血小板和红细胞内钙增高可引起血小板聚集和红细胞变形能力的异常,脂代谢异常,并能刺激内皮引起血管平滑肌增生,导致冠心病的发生,因此认为细胞内钙含量增加是早期诊断冠心病和正确使用钙拮抗剂的客观指标之一。     

血塞通辅助治疗冠心病患者的效果及对血液流变学的影响

目的 探讨血塞通治疗冠心病患者的效果及对血液流变学的影响。方法 选取2021年6月至2022年7月在我院心内科进行治疗的174例冠心病患者,按照患者入院时间顺序将其均分为两组,即研究组与对照组,每组87例。对照组采用硝酸异山梨酯片、硝苯地平片、阿司匹林肠溶片治疗,研究组在对照组基础上联合血塞通辅助治疗,观察两组患者的治疗效果、血液流变学及生活质量。结果 研究组总有效率高于对照组（P <0.05）;治疗后,研究组全血低切黏度、全血高切黏度、血浆黏度均低于对照组（P <0.05）;研究组生活质量评分高于对照组（P <0.05）。结论 在冠心病基础药物治疗的基础上结合血塞通辅助治疗,能够明显改善患者的血液流变学水平,提升治疗效果。     

血清甘油三酯及胆固醇对血液黏度和红细胞流变性的影响

近两年来,我们通过对受试对象血脂和血液流变学检测,探讨了血清甘油三酯(TG)及胆固醇(TC)对血液黏度和红细胞流变性的影响,为临床高脂血症及血栓性疾病的防治提供新的思路和方法。     

冠心病患者“天保宁”治疗前后血液流变学指标的变化

检测76例冠心病患者用“天保宁”(银杏叶制剂）治疗前后红细胞压积、红细胞沉降率红细胞沉降率方程K值、血浆纤维蛋白原，血浆粘度和4s^-1、10s^-1、20s^-1、40s^-1、100s^-1、200s^-1；切变率时全血表观粘度值；其结果表明，与治疗前相比较，治疗后的红细胞压积血浆纤雏蛋白原、血浆粘度和不同切变率时的全血表观粘度值均显著降低(P&;lt;0.001)，红细胞沉降率和红细胞沉降率方程K值均显著升高(P&;lt;0.001)；提示“天保宁”异有哪显改善冠心病患者血液流变学特性的作用，有益于对冠心病的预防和治疗。     

老年冠心病患者血液流变学测定

目前巳公认血液流变学的变化与心血管疾病的发生、发展也有着密切的关系。近年研究也颇受重视。本现对老年前期、老年期冠心病患的血液流变学变化情况作一报告．     

吸烟对血液流变学指标影响的分析

吸烟已被公认为是冠心病的主要危险因素之一[1].吸烟可引起某些抗氧化物活性的改变,吸烟者红细胞对过氧化物的敏感性增高,血浆中共轭二烯浓度升高,提示脂质过氧化物的增加[2].但是,吸烟是否会导致血液流变学指标的改变未见报道.为此,我们对两组同体质的健康男性吸烟者和健康男性不吸烟者进行了血液流变学指标的检测调查,并对其结果进行了分析.     

冠心病患者银杏叶制剂治疗前后血液流变学特性改善的研究

近年来国内外的一些研究表明，银杏叶制荆由于内含黄酮甙和银杏苦内酯等．因而能降低毛细血管通透性，改善血管脆性．高效拈抗血小板活化因子引起的血小板聚集和微血栓形成，改善体内血液动力学和血液流变学特性．改善冠状动脉循环，增加冠脉流量，降低心肌耗氧量等，可用于动脉硬化、冠状动脉供血不足、心绞痛、心肌梗塞、脑血栓和脑血管痉挛等治疗。为探讨银杏叶制剂在治疗冠心病患时的改善血液流变学特性作用，本检测了76例冠心病患用。     

益心舒胶囊对中老年冠心病患者血液流变学的影响

目的观察益心舒胶囊对中老年冠心病患者临床症状、心电图及血液流变学的影响。方法197例中老年冠心病患者随机分为两组,对照组给予硝酸酯类、美托洛尔及他汀类等常规治疗,治疗组在常规治疗基础上加服益心舒胶囊,观察两组患者治疗前后临床症状、心电图及血液流变学指标的变化。结果治疗组服用益心舒胶囊1个月后临床症状及心电图改变均有明显好转(P0.01),血液流变学多项指标明显改善(P0.01),与对照组治疗后比较差异有统计学意义(P0.01)。结论益心舒胶囊对中老年冠心病患者的临床症状、心电图及血液流变学有改善作用。     

自血光量子疗法对老年冠心病血液流变学的影响

近年来大量的研究资料表明老年冠心病患血液流变学明显异常,因此降低血液粘度,在老年冠心病的治疗中颇受重视。我们自1992年以来应用自血光量子疗法(UBI)治疗老年冠心病38例,观察了该疗法对血液流变学的影响，现报道如下。     

Heparin effect on blood viscosity

The effect of heparin on blood viscosity was investigated in a group of patients with acute myocardial infarction (AMI) and preinfarction angina (PA), whose blood viscosity was elevated. Viscosity was measured with Cannon, Fenske, and Routine viscometers. Kinematic viscosity, bath and whole blood, plasma, and serum viscosity were determined as well as dependent parameters (fibrinogen, serum proteins, number of platelets, and hematocrit). All of them were found to increase, and it was significantly proved that intravenous heparin immediately decreased plasma viscosity, but has a lesser effect on serum and whole blood viscosity. A dose of 1 cc = 50 mg = 5000 IU intravenous heparin, will maintain this decrease for a month. In our four-week study, 1 cc i.v. heparin was administered at 6-hour intervals for the first 2 weeks, and 2 cc heparin subcutaneous injections were administered at 12-hour intervals for the next 2 weeks. We found that heparin also decreased fibrinogen, hematocrit, serum alpha₂ globulin, and number of platelets. Hyperviscosity, hypercoagulability, and the increase of platelet adhesiveness are some of the most important physiopathological alterations of AMI and PA. The decrease of blood viscosity due to heparin is one of the most important and beneficial effects of it in this pathology.     

Effect of abnormal protection on coronary artery disease in patients withliver cirrhosis

AIM To probe into the effect of abnormal protection on coronary artery disease (CAD) in patients withliver cirrhosis (LC).METHODS Fifty-two cases of LC associated with diabetes mellitus (DM) and 63 cases of simple DM werecompared prospectively. Blood biochemistry, blood viscosity and ECG were examined carefully every threemonths, and the three-year morbidities CAD in both groups were monitored dynamically.RESULTS There were significant decreases in blood biochemistry and viscosity in LC group as comparedwith those in control (P<0.05 or 0.01), and there was a more significant decrease in ST-T abnormality ratein LC group than in the simple DM group (P<0.05). As a result, the three-year morbidity of CAD in LCgroup was 64% lower than in the control 1group.CONCLUSION There is truly an abnormal protection against CAD in patients with LC.     

Impaired erythrocyte fluidity during treatment of renal anaemia with erythropoietin.

Seventeen haemodialysis patients with renal anaemia were treated with recombinant human erythropoietin (rhEPO) and observed for 30 weeks. The viscosity of whole blood and plasma, the erythrocyte aggregation tendency, and the erythrocyte deformability, measured as fluidity, were analysed every second week. All patients responded with increasing haematocrit and whole-blood viscosity. The plasma viscosity and the erythrocyte aggregation tendency were already increased before the start of treatment, and remained unchanged during treatment. The basal erythrocyte fluidity tended to be impaired, although not significantly so. During treatment, significant impairment of fluidity was observed at the beginning of the treatment period. After 24 weeks the fluidity started to increase, and it later reached values observed before the start of treatment. Hence, the quality of the erythrocytes formed during the corrective phase of rhEPO treatment differs in some respects from that of cells formed at a normal production rate. The impaired fluidity might have important implications for the flow resistance in small vessels, and contribute to the development or aggravation of hypertension that is often seen during rhEPO treatment.     

Therapeutic effect of recombinant human erythropoietin on anaemia with erythropoietin deficiency in diabetic patients.

AIMS: The aim of this study was to investigate the therapeutic effect of recombinant human erythropoietin (rHuEpo) on anaemia with erythropoietin deficiency in diabetic patients. METHODS: Twenty diabetic patients with anaemia and Epo deficiency were enrolled. All patients were treated with rHuEpo (Epokine; 4000 U/day s.c., three times a week) for 8 weeks. RESULTS: The responder group (n = 14) had significant increments in haemoglobin compared with the non-responder group (n = 6) (P < 0.05). No significant differences were found between the responder and non-responder groups in terms of duration of diabetes mellitus, serum creatinine level, 24-h urine albumin excretion rates, frequency of diabetic microangiopathy, or HbA1c. There was no difference between the two groups in terms of serum iron and total iron-binding capacity (TIBC). Serum ferritin level was significantly higher in the responder group than in the non-responder group (240.3 +/- 108.4, 25.8 +/- 3.0 micro g/l, P < 0.05), as was transferrin saturation (32.7 +/- 7.9%, 21.2 +/- 5.3%, P < 0.05). CONCLUSIONS: rHuEpo could be useful in the treatment of anaemia with erythropoietin deficiency in diabetic patients, and the degree of iron storage and functional iron deficiency might be the main cause of hyporesponsiveness to rHuEpo.     

非酒精性脂肪肝血瘀证患者血液流变学变化

[目的]观察非酒精性脂肪肝并符合血瘀证诊断患者的血液流变学变化,探讨血液流变学对其诊断的实用价值,为临床使用中医活血化瘀法提供理论依据.[方法]选择非酒精性脂肪肝血瘀证者42例,采用LIANG-100血液黏度计及TILSEAGCH100比色计测定其血液流变学指标的变化,并与37例健康成人进行对照.[结果]非酒精性脂肪肝血瘀证患者全血黏度(高切300 1/s、中切115 1/s、低切1 1/s)、红细胞聚集性、血浆黏度和纤维蛋白原等指标均有明显改变,与对照组比较差异有统计学意义(P＜0.0 5).[结论]非酒精性脂肪肝并血瘀证患者适合使用活血化瘀疗法,血液流变学指标可作为一种观察临床疗效的定量指标.     

人促红素减少老年全膝关节置换术后输血的临床对照研究

目的探讨控制老年患者人工全膝关节置换术（TKA）手术出血量、减少术后同种输血需要量,降低患者输血率的方法。方法选取60例拟行TKA的老年病人,随机分成3组：试验组20例,术后不引流,采用围手术期静注重组人促红素;对照组20例,术后不予引流;常规手术组20例,术后常规留置引流管。比较3组术前、术后1 d、7 d、2周时血红蛋白（Hb）、红细胞比积（Hct）,以及术后并发症和膝关节功能康复情况。实际失血量等于通过手术前后Hct变化计算的理论值加上额外的输血量和自体回输血量。通过观察输血量、用差值来比较术前和术后各观察时间点的Hb动态变化,来评估患者术后同种输血需要量是否减少。结果术后3组切口均Ⅰ期愈合。随访时间12~22月。常规引流组较试验组和对照组术后出血量明显增加;试验组术后Hb减少最少;3组术后膝关节功能无明显差异。结论术后不引流加静注重组人促红素是控制TKA手术出血量、减少术后同种输血需要量的有效方法之一。     

Serial changes in endogenous erythropoietin levels in patients with myelodysplastic syndromes and aplastic anemia undergoing erythropoietin treatment

Summary Recombinant human erythropoietin (rhEpo) was administered to 14 patients with myelodysplastic syndrome (MDS) and seven patients with aplastic anemia (AA). In 19 patients, doses of 6000 units were given intravenously three times a week (t.i.w.) with the dose being doubled up to 24000 units every 8 weeks until a response was obtained. RhEpo was given subcutaneously in two patients. Seven patients, four with MDS and three with AA, showed a significant response with an increase of hemoglobin concentration during therapy. The response occurred at doses of 12000 units in five and 24 000 units in two patients. Responding patients with both MDS and AA had a relatively low serum Epo (s-Epo) level prior to Epo therapy. MDS responders had either refractory anemia (RA) or RA with ring sideroblasts (RARS), while two of the Epo responders in AA had a severe form of the disease. However, since some of the Epo responders had a high initial s-Epo concentration, a high s-Epo level does not preclude the use of rhEpo. Serial determination of s-Epo levels showed a progressive decline in six of the seven responders even when they were on rhEpo therapy, while the s-Epo levels remained elevated or further increased with time in most nonresponders. RhEpo was well tolerated by all patients. The results suggest that rh-Epo is a safe and effective treatment for a certain proportion of patients with MDS and AA. Moreover, serial determination of s-Epo during therapy may be useful in monitoring and predicting the therapeutic effect of rhEpo.This work was supported by grants (63480277, 03671185, 03151057) from the Ministry of Education, and Grants for Intractable Disease from the Ministry of Health of Japan     

Dynamic changes of HBV DNA in serum and peripheral blood mononuclear cells of chronic hepatitis patients after lamivudine treatment

AIM: To study the dynamic changes of hepatits B virus (HBV) DNA in serum and peripheral blood mononuclear cells (PBMCs) of patients after lamivudine therapy. METHODS: A total of 72 patients with chronic HBV infection were included in this study. All patients were confirmed to have the following conditions: above 16 years of age, elevated serum alanine amonotransferase (ALT), positive hepatitis B e antigen (HBeAg), positive HBV DNA in serum and PBMCs, negative antibodies against HAV, HCV, HDV, HEV. Other possible causes of chronic liver damages, such as drugs, alcohol and autoimmune diseases were excluded. Seventy-two cases were randomly divided into lamivudine treatment group (n=42) and control group (n=30). HBV DNA was detected both in serum and in PBMCs by fluorescence quantitative polymerase chain reaction (PCR), during and after lamivudine treatment. RESULTS: In the treatment group, HBV DNA became negative both in serum and in PBNIC, of 38 and 25 out of 42 cases respectively during the 48 wk oflamivudine treatment, the negative rate was 90.5% and 59.5% respectively. In the control group, the negative rate was 23.3% and 16.7% respectively. It was statistically significant at 12, 24 and 48 wk as compared with the control group (P < 0.005). The average conversion period of HBV DNA was 6 wk (2-8 wk) in serum and 16 wk (8-24 wk) in PBMC. CONCLUSION: Lamivudine has remarkable inhibitory effects on HBV replication both in serum and in PBMCs. The inhibitory effect on HBV DNA in PBMCs is weaker than that in serum.     

血管内激光照射对犬急性心肌缺血区血液流变学的影响

健康杂种犬,开胸分离冠状动脉前降支,并造成冠状动脉狭窄。在狭窄１２０ ｍ ｉｎ 后将ＨｅＮｅ激光（输出功率２．４６±０．１１ ｍ Ｗ）经石英光纤插入下肢体大动脉,照射６０ ｍ ｉｎ。照射后其全血高切和低切粘度较照射前各减少１１％ 和１４％ ,血浆粘度降低６％ ,红血细胞压积减少５％ ,纤维蛋白原下降１４％ ,均变化显著。对照组则无显著性变化。结果表明激光血管内照射（ＩＬＩＢ）可降低纤维蛋白原浓度,改善红细胞的变形性,进而导致血浆粘度与全血粘度降低,改善血液的流动性