急性心肌梗塞的血液流变学变化及其与病情的关系

本文观察50例急性心肌梗塞(AMI)、30例陈旧心肌梗塞(OMI)、34例其他心脏病并发心力衰竭(简称心衰)、休克者和40例正常人的血液流变学指标。结果表明,AMI可导致血液流变性异常改变,7项流变学指标显著高于正常组(P<0.05～0.001);除红细胞压积(HCT)和高切全血粘度外,其余指标显著高于OMI组(P<0.05～0.001)。随病程进展,诸指标逐渐降低。AMI并发心衰、休克者全血粘度、血浆纤维蛋白原(Fb)和红细胞刚性T_k值显著高于无并发症和其他心脏病并心衰、休克者(P<0.05～0.001);AMI和其他心脏病并休克者的红细胞T_k值无差异(P>0.05),提示血液流变学指标可作为AMI判断病情、估计预后的重要参数。

CHANGES OF BLOOD RHEOLOGY IN ACUTE MYOCARDIAL INFARCTION AND ITS RELATION TO THE CLINICAL COURSE

The indices of blood rheology of 50 patients with acute myocardial infarction (AMI), 30 cases with old myocardial infarction (OMI), 34 patients with other heart diseases, heart failure or shock and 40 normals were observed. The results showed that AMI might induce abnormal changes of blood theology. All of the seven indices of blood rheology in AMI group were significantly higher than those in. normal group (p<0. 05 - 0. 001). Besides HCT and whole blood viscosity, the other indices in AMI group were significantly higher than those in OMI group (p<0.05-0.001). With progression of the disease all indices of blood theology reduced gradually. Whole blood viscosity, plasma fibrinogen and TK titer of red cell in AMI patients with heart failure or shock were significantly higher than those either in AMI without heart failure or shock (p<0.05-0.001) or other heart disease with heart failure (p<0.05-0.001). Whole blood viscosity and plasma fibrinogen in AMI patients with shock were significantly higher than those in other heart disease with shock (p<0.05-0.001). The results suggest that indices of blood rheology may he important parameters for evaluating the clinical condition and prognosis of AMI.