老年气虚血瘀型胸痹患者血液流变性及红细胞膜组分变化研究

目的:探讨老年气虚血瘀型胸痹患者血液流变性及红细胞膜组分变化.方法:18例老年气虚血瘀型冠心病(胸痹)患者,以健康老年人13例和健康青年人10例为对照,取血测血液流变学指标以及红细胞膜组分相关指标.结果:冠心病组全血黏度在低、中、高切变率分别为(24.08±4.85),(8.48 ±1.81),(5.51±1.27) mPa·s],与健康老年人(20.26±2.76),(7.36±0.81),(4.71 ±0.54)mPa·s]和健康青年入(17.04±5.26),(6.53±1.38),(4.16±0.61)mPa·s]比较显著升高(P ＜0.05或P＜0.01)；冠心病人组血浆黏度(1.56 ±0.078) mPa·s]与健康老人组(1.26±0.095) mPa·s]和青年人组(1.25±0.053)mPa·s]比较均显著升高(P＜0.01)；冠心病人组红细胞变形性在600 s-1为46.55±2.37,显著低于健康老人组(49.25±3.70,P＜0.05),800,1000 s-1下冠心病组为(47.70±2.54,48.93±2.46)明显低于青年人组(52.35±2.43,53.07±2.57)(P＜0.05);与健康老年人组(5.07±0.34) μmol·mg-比较,冠心病组红细胞膜上胆固醇(6.09±1.44)μ mol·mg-1含量明显升高(P＜0.05)；而膜上唾液酸含量(2.01±0.42)mmol·mg-1]明显低于青年组(2.82 ±0.70)mmol·mg-1]；巯基含量(0.039±0.019) mmol· mg-1]低于健康老人组(0.059±0.022)mmol·mg-1,P＜0.05]和青年组(0.070±0.011)mmol·mg-1,P ＜0.01]；Na+-K+-ATP酶活性和SOD活性降低,丙二醛含量升高,但无统计学意义.结论:气虚血瘀型冠心病心绞痛患者的全血黏度、血浆黏度显著升高,红细胞变形能力明显降低,其机制可能是由于红细胞表面唾液酸含量和巯基含量减少,膜胆固醇含量增多有关.

Hemorheological Parameters and Erythrocyte Membrane Components in the Senile Patients of Coronary Heart Disease with Qi Deficiency and Blood Stasis

Objective:To investigate the change in hemorheological parameters and components of erythrocyte membrane of the senile patients of coronary heart disease with qi deficiency and blood stasis.Method: Eighteen coronary heart disease patients with qi deficiency and blood stasis,thirteen healthy old people and ten healthy young people were divided into coronary patient group and healthy old people control group and healthy young people control group.Many indexes,including biochemical indicators of plasma,whole blood viscosity,plasma viscosity,erythrocyte deformability and the content of cholesterol,sialic acid,hydrosulphonyl,MDA,activity of SOD,Na+-K+-ATP enzyme activity of erythrocyte membrane were determined.Result: The whole blood viscosity at low,middle and high shear rates of the coronary heart disease group were (24.08±4.85),(8.48±1.81),(5.51±1.27) mPa · s] respectively.Compared with healthy elderly group (20.26±2.76),(7.36±0.81),(4.71±0.54) mPa · s] and healthy young group (17.04±5.26),(6.53±1.38),(4.16±0.61) mPa · s],the whole blood viscosity of the coronary heart disease group was increased significantly(P<0.05,P<0.01).The plasma viscosity of the coronary patient (1.56±0.078) mPa · s] was significantly higher than that of the healthy elderly group (1.26±0.095) mPa · s] and healthy young group (1.25±0.053) mPa · s](P<0.01,P<0.05).The red cell deformability index of the coronary heart disease group under 600 s-1(46.55±2.37) was lower than that of healthy elderly group(49.25±3.70)(P<0.05);Under 800,1000 s-1,the coronary heart disease group(47.70±2.54 and 48.93±2.46) were lower than those of healthy young group(52.35±2.43,53.07±2.57)(P<0.05).The contents of cholesterol in erythrocyte membrane of the coronary heart disease group(6.09±1.44) μmol · mg-1 were significantly higher than that of the healthy elderly group(5.07±1.44) μmol-1 · mg-1(P<0.05).The contents of sialic acid of coronary heart disease group(2.01±0.42) mmol · mg-1 were significantly lower than that of the healthy young group(2.82±0.70) mmol · mg-1.And hydrosulphonyl in erythrocyte membrane in the coronary heart disease group(0.039±0.019) mmol · mg-1 was significantly lower than that of the healthy elderly group(0.059±0.022) mmol · mg-1,(P<0.05) and the healthy young group(0.070±0.011) mmol ·mg-1,(P<0.01),SOD and Na+-K+-ATP enzyme activities of erythrocyte membrane were decreasing and the content of MDA was increasing.However,there were no statistically difference.Conclusion: The whole blood viscosity and plasma viscosity in the senile patients with qi deficiency and blood stasis are increased significantly and the red cell deformability is decreased distinctly.The mechanism may be related to the increase in membrane sialic acid and cholesterol,and the decrease in hydrosulphonyl.