终末期肾病患者肾移植后血液流变性之变化

研究终末期肾病肾移植后血液流变性的改变并探讨其临床意义。结果表明，肾移植后肾功能正常时，低切至高切变率时的全血粘度明显增高，甚至高于正常人。全血粘度的升高主要与红细胞比积、血浆粘度、红细胞聚集指数、Ｃａｓｓｏｎ粘度的增高有关，与红细胞的变形能力及血液屈服应力无明显关系。肾移植后肾功能失活时，红细胞比积及Ｃａｓｓｏｎ粘度降低，使低切至高切变率时的全血粘度降低，但血浆粘度仍明显高于正常对照组。提示，肾移植后肾功能正常时，血液的流变特性明显障碍，血液粘度尤其是血浆粘度升高，这可能是肾移植后肾功能失活的重要发病机理，也是血管栓塞性合并症发生的病理基础。

Hemorheological Changes in Recipients of Cardaveric Kidney Transplantation

Hemorheologic alterations and clinical significance of these changes were studied in 12 recipients of cadaveric kidney transplantation. The results showed that the whole blood viscosities at lower(3.84s-1) to higher(384.00s-1) shear rates in recipients with normal graft function were remarkably increased compared with those before transplantation,even normal people;those elevated blood viscosities were mainly responsible for the increasing of plasma viscosity, hemotocrit,Casson viscosity, red blood cell aggregation,and no significant relationship with the changes of blood stress and deformability of the erythrocytes. The whole blood viscosities at lower to higher shear rates in recipients with graft failure were remarkably decreased,those decreased blood viscosities were mainly responsible for the decreasing of hemotocrit and Casson viscosity,the plasma viscosities in recipients with graft failure was remarkably increased than normal controls. Those results suggest that the disturbances of hemorheology in recipients with normal function, especially increasing of plasma viscosities were an important mechanism of graft failure and pathologic basis of thromboembolism.