急性心肌梗塞血液流变学动态改变与预后关系

对21例急性心肌梗塞(acute myocardial infarction,AMI)治疗过程中血液流变学(hemorrheology)动态观察发现:(1)全血低切比粘度和还原粘度、全血高切比粘度和还原粘度及红细胞聚集指数在AMI发生后1～3天升高提示预后不良。(2)血浆粘度改变对预后影响不大。表明动态监测血液流变学指标对判断AMI的预后有重要意义。

A Study on the Relationship between the Prognosis of Acute Myocardial Infarction and the Dynamic Changes of Hemorrheology

The dynamic changes of hemorrheology were studied in 21 cases of acute myocardial infarction (AMI) during the course of treatment with capillary tube viscosity device. We found that: (1) In group A (good prognosis group), the levels of whole blood relative viscosity and reductive viscosity in low shearing stress, the whole blood relative viscosity and reductive viscosity in high shearing stress, and the red blood cell gathering index declined in 1-3 days after AMI, and they reelevated a week later. The levels were basically stable in the 3rd week. But in group B (bad prognosis group), they reelevated in 1-3 days after AMI. (2) The change of plasma viscosity did not affect the prognosis of AMI. We consider that blood viscosity reelevation after AMI can reduce the blood supply to the marginal zone of infarction. So ischemia and anoxia will take place and the extension of the infarction area will result, this might increase the mortality rate of AMI. Therefore that continual detection of hemorrheologic indices is of great significance to predict the prognosis of AMI.