银屑病患者微循环与血液流变性变化

目的:观察银屑病患者微循环障碍与血液流变性变化在银屑病发病机制中的作用。方法:对银屑病患者多项血液流变性指标以及甲襞微循环进行检测,并与正常健康人群进行对比分析。结果:银屑病组与对照组比较:全血粘度(ηb)、血浆粘度(ηp)、红细胞聚集指数(EAI)、红细胞硬度(TK值)、血沉、血沉方程K值均明显升高(P均<0.01),红细胞压积(Hct)无明显差异(P>0.05)。银屑病组管袢模糊,畸形管袢增多,袢顶狭窄较多见,输入枝血管变细,输出枝血管增粗,管袢缩短;微血管血流速度缓慢,多呈粒流、粒缓流,红细胞聚集,可见白色微小血栓;管袢周围视野极度模糊,袢顶渗出或出血,乳头呈浅波纹状或平坦;用田牛加权积分法分析,银屑病患者甲襞微循环明显异常,其形态、流态、袢周等指标积分值以及综合积分值与对照组比较,有显著性差异(P均<0.01)。银屑病组ηb低切值、EAI、血沉与甲襞微循环流态积分值及综合积分值均呈明显正相关(与流态积分值的相关系数r分别为0.28、0.29、0.21;与综合积分值的相关系数r分别为0.26、0.24、0.19;P均<0.01)。结论:微循环障碍是银屑病的发病机制之一,微循环改变的机理可能与血液粘度增高,毛细血管扩张以及通透性增加有关。临床上采用降低血液粘度,改善微循环的药物治疗有助于患者康复。

The Dependablity Study of Hemorrheology and Microcirculation of Patients with Psoriasis

Objective:To investigate the dependablity of hemorrheology and microcirculation obstacle of patients with psoriasis and the effective in pathogenesy of psoriasis.Method:The hemorrheology,nailfold microcirculation were measured in patients with psoriasis and aggregate consrasting analysis with normal people.Results:The comparision of psoriasis and control:ηb,ηp,EAI,TK,erythrocyte sedimentation rate,blood sedimentation K were significantly increased.Pipe loop dim,there are more abnormal Pipe loop and top stegnosis,input vessel become light and output thickness.Pipe loop decurtate,the velocity of microvessel blood become slow,more are granule flow,erythrocyte aggregation,can find white microthrombus.The surrounding visual field of pipe loop deep dim.Top loop bleed,mamilla smooth.After analysis,patients with psoriasis has abnomal nailfold microcirculation;It's form,fluid state,and loop surrounding score and aggregate score have significantly difference(P<0.01) contrasting with normal people.The psoriasis ηb EAI,erythrocyte aggregation and nailfold microcirculation fluid state score and aggregate score with an obvious positive correlation.(contrasting with fluid state score r=0.28,0.29,0.21;contrasting with aggregate score,r=0.26,0.24,0.19;P<0.01).Conclusion:Microcirculation obstacle is one of the pathogenesy of psoriasis.The mechanism of change of microcirculation is possible related with the increase of blood consistency,angiotelectasis and permeability increase.The clinical effect of psoriasis is good treated with change of microcirculation drug and decreased the blood viscosity.