The effect of polycythemic hyperviscosity on ischemic bowel necrosis

It is known that polycythemia decreases the fluidity of the blood and impairs tissue perfusion due to red-cell sludging in the microcirculation. In this study, the effect of polycythemic hyperviscosity (PH) on bowel necrosis was evaluated in an experimental model of intestinal ischemia. Twenty-eight Wistar albino rats (90–170 g) were divided into two groups: group 1 was transfused to create hyperviscosity and then intestinal ischemia was produced (n = 16); in group 2 ischemia was produced without transfusion (n = 12). Intestinal ischemia was produced by clamping the superior mesenteric artery and the collateral arcades of the right colic artery for 30 min. Gross and histopathologic evaluations were performed by either immediate necropsy or relaparotomy 24 h later. Microscopic findings were graded from 0 to 3 according to the degree of ischemic changes. In group 1, 2 animals (12.5%) died before 24 h postoperatively; coagulation necrosis with grade 2 or 3 ischemic changes was observed in 10 animals (62.5%). In group 2 only a few hypertrophied Peyer's patches and capillary dilation were found, and all histopathologic changes were between grades 0 and 1. The difference between the histopathologic gradings of the two groups was significant (P < 0.001). It appears that in addition to reduced splanchnic blood flow, a secondary effect of PH is needed to induce ischemic coagulation necrosis. PH of the newborn must be considered a risk factor for necrotizing enterocolitis, so-called spontaneous intestinal perforations, and even intestinal atresia.Presented at the 1st European Congress of Pediatric Surgery, Graz/Austria, May 4–6, 1995     

高黏滞血症模型兔血管内皮细胞分泌功能变化及活血化瘀中药干预作用研究

目的 :观察活血化瘀中药对高黏滞血症血管内皮分泌功能的影响 ,探索中药治疗该病的作用机制。方法 :采用复合因素 (高分子右旋糖酐、肾上腺素、牛血清白蛋白 )、长时间 (112 d)造高黏滞血症兔模型 ,随机分为益气活血、滋阴活血和活血化瘀 3个治疗组 ,观察高黏滞血症血管内皮细胞分泌功能及 3类活血组方的干预作用。结果 :(1)模型组、空白对照组高黏滞血症模型兔血浆血栓素 B2 (TXB2 )和内皮素浓度显著升高 ,而 6 -酮 -前列腺素 F1α浓度显著降低。(2 )活血化瘀类中药能显著降低高黏滞血症模型血浆 TXB2 水平。 (3)益气活血、滋阴活血及活血化瘀组方对高黏滞血症模型兔血浆 6 - keto- PGF1α水平有不同程度的升高趋势。(4 )益气活血及单纯活血化瘀类中药能显著降低高黏滞血症模型兔血浆内皮素水平。结论 :血管内皮细胞可能是活血化瘀中药治疗作用靶点之一。     

分离红细胞回输自体血浆治疗老年肺心病高粘血症的临床应用

目的 分离出多余的红细胞,降低老年肺心病高粘血症的血液粘度,以改善心肺功能。方法 每例病人采血200ml,共采3次,血液进行离心、热合、分浆,分离出的红细胞废弃,血浆立即通过保留的静脉通道,全部回输给病人。结果 细胞压积下降1.71%,全血粘度低切平均下降0.72,血浆比粘度平均下降0.05,血红蛋白平均下降1.28/L,经统计学处理均有显著性差异（P＜0.01）。结论 该疗法降低了高粘血症的血液粘度,改善了心肺功能。     

当归总苯酞活血化瘀作用的实验研究

目的 观察当归总苯酞在活血化瘀方面的功效。方法 大鼠ig给予当归总苯酞（生药1、2、4 g/kg),观察当归总苯酞对大鼠实验性动脉血栓形成及血小板聚集功能的影响;采用高分子右旋糖酐制备高黏血症大鼠模型,观察当归总苯酞对大鼠血液黏度的影响;观察当归总苯酞对大鼠凝血相关指标的影响。结果 当归总苯酞（生药1、2、4 g/kg）能延长大鼠实验性动脉血栓的形成时间（P＜0.05、0.01）;降低高分子右旋糖苷所致的高黏血症大鼠全血、血浆、血清黏度（P＜0.05）;抑制花生四烯酸（AA）、腺苷二磷酸钠（ADP）、胶原（CG）诱导的血小板聚集功能（P＜0.05、0.01、0.001）;明显延长大鼠凝血酶时间（TT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）（P＜0.05、0.01、0.001）。结论 当归总苯酞具有显著的活血化瘀作用,表现为延长实验性动脉血栓的形成时间;改善高黏血症模型大鼠的全血及血浆黏度;抑制血小板聚集功能;影响凝血系统,延长大鼠TT、PT、APTT等指标。     

Hemoglobin sickle cell disease complications: a clinical study of 179 cases

Background

Hemoglobin sickle cell disease is one of the most frequent hemoglobinopathies. Surprisingly, few studies have been dedicated to this disease, currently considered to be a mild variant of homozygous sickle cell disease. The aim of this study was to update our knowledge about hemoglobin sickle cell disease.

Design and Methods

The study involved a single center series of 179 patients. Clinical and biological data were collected with special attention to the assessment of pulmonary arterial hypertension and nephropathy.

Results

Hemoglobin sickle cell diagnosis was delayed and performed in adulthood in 29% of cases. Prevalence of hospitalized painful vasoocclusive crisis, acute chest syndrome and priapism was 36%, 20% and 20%, respectively. The most common chronic organ complications were retinopathy and sensorineural otological disorders in 70% and 29% of cases. Indeed, prevalence of complications reported in homozygous sickle cell disease, such as nephropathy, suspicion of pulmonary hypertension, strokes and leg ulcers was rather low (13%, 4% and 1%, respectively). Phlebotomy performed in 36% of this population (baseline hemoglobin 11.5 g/dL) prevented recurrence of acute events in 71% of cases.

Conclusions

Our data suggest that hemoglobin sickle cell disease should not be considered as a mild form of sickle cell anemia but as a separate disease with a special emphasis on viscosity-associated otological and ophthalmological disorders, and with a low prevalence of vasculopathy (strokes, pulmonary hypertension, ulcers and nephropathy). Phlebotomy was useful in reducing acute events and a wider use of this procedure should be further investigated.     

糖复康胶囊治疗糖尿病肾病的主要药效学研究

目的观察糖复康胶囊对糖尿病肾病的治疗作用。方法采用糖尿病。肾病、高血糖、血瘀等实验模型,观察、测定相应的实验指标。结果糖复康胶囊对糖尿病肾病有明显的防治作用;降低高血糖动物的血糖;抑制高分子右旋糖酐所致大鼠全血黏度的升高;抑制动脉血栓形成。结论糖复康胶囊对糖尿病肾病有明显的防治作用。     

磁性远红外寝具对高粘滞血症患者血液流变学的影响

目的:观察磁性远红外寝具对高粘滞血症患者血液流变学的影响.方法:60例高粘滞血症患者,按随机数字表法分为实验组30例和对照组30例.实验组每晚(6～8小时)均使用磁性远红外寝具,连续2个月.对照组用普通寝具.两组均于实验前后取全血,测定血液流变学的各项指标.结果:实验组实验后的血浆粘度以及在高切变率(200s-1)、中切变率(100s-1,30 s-1)及低切变率(3 s-1)下的全血粘度,均较实验前明显下降,差异具有显著性或非常显著性(分别为t=5.4169及2.7462、2.6429、2.5538、3.6177,p＜0.05或p＜0.01):血沉、血沉方程k值、红细胞聚集指数、红细胞刚性指数、红细胞电泳时间及血浆纤维蛋白原等项指标,亦分别较实验前明显下降、缩短及减少,差异显著或非常显著(分别为t=2.654.2.7119、2.3717、2.3006、3.1477、5.1827,p＜0.05或p＜0.01),对照组实验后以上各项指标较实验前均无明显变化,差异均无显著性(p＞0.05).结论:磁性远红外寝具有降低血液粘度,改善血液流变特性的作用.     

Prolonged carboxyhemoglobin clearance in a patient with Waldenström's macroglobulinemia

The case of a patient with elevated carboxyhemoglobin saturation, prolonged carboxyhemoglobin half-life, and Waldenström's macroglobulinemia is presented. In vitro studies on the patient's blood showed that the half-life of carboxyhemoglobin in the macroglobulinemic blood was about three times longer than in a normal blood sample. Similar experiments using normal and macroglobulinemic blood samples were done in which the macroglobulinemic plasma was replaced by normal saline, and there was no difference in the half-lives. Therefore, we believe the plasma phase played a significant role as a barrier to carbon monoxide transfer in this patient. The mechanism of this impairment is unclear at this time. Nonetheless, impaired carbon monoxide transfer in plasma has not been noted before and potentially has both diagnostic and therapeutic implications.     

高粘血症96例诊治体会

文章报道 96例高粘血症的诊治体会。认为只有正确认识血液流变学指标 ,对高粘血症进行正确分型 ,结合病人的机能状态 ,才能指导制定合理的治疗方案 ,采取有针对性的治疗措施和药物以提高疗效。避免盲目使用“降血粘”药物。