冬季南方老年脾胃虚寒性胸痹患者血液流变学及凝血功能研究

目的观察南方冬季老年脾胃虚寒性脚痹患者血液流变学及凝血指标的变化，为临床诊疗提供新思路。方法回顾性分析2009~2011年冬季，老年脾胃虚寒性胸痹患者（观察组）与正常对照组血液流变学、凝血功能指标并进行比较，其中男性各48例，女性各72例，采用半自动血液黏度计、全自动血细胞、血凝和生化分析仪进行样品检测。结果血液流变学显示：全血黏度（wholebloodviscosity）、红细胞数量（RBC）、血红蛋白浓度（Hb）、红细胞压积（Hct）、血沉（ESR）、血糖（Glu）、三酰甘油（TG）、胆固醇（Cho）、总蛋白（TP）、清蛋白（A）、球蛋白（G）降低，与对照组相比差异具有统计学意义（P〈0．05或P〈0．01），血浆黏度与对照组相比差异无统计学意义（P〉0．05）；凝血分析显示：凝血酶原时间（PT）、部份活化凝血酶原时间（APTT）缩短，纤维蛋白原（FIB）、D-二聚体（DD）升高，与对照组相比差异具有统计学意义（P〈0．05或P〈0．01）。结论冬季脾胃虚寒性胸痹患者血液流变学指标改变可能是由于长期消化、吸收不良而导致长期营养物质缺乏乖红细胞数量、压积偏低而引起。高凝状态是由于器官、组织缺血、缺氧和寒冷损伤，激活凝血系统所导致。

Research of Hemorheology and Coagulation Function in Elderly Patients with Chest Impediment of Type belong to Weakness of Spleen and Stomach in Southern China in Winter

Objective To observe the changes of hemorheology and coagulation system in elderly patients with deficiency cold of spleen-stomach secondary chest impediment in southern China in winter. Analyse the cause and supply new thinking to clinical diagnosis. Methods The hemorheological indexes and blood coagulation function between elderly patients with defi- ciency cold of spleen stomach after secondary thoracic obstruction （observation group） and control group in southern China in winter were measured by blood viscometer,automatic blood cell analyzer,blood coagulation analyzer and automatic bioche mical analyzer, were retrospectively reviewed and compared. Two groups contained each 48 males and 72 females. Results Many hemorheology and coaglation indexes of observation group were significantly changesd compared with those of normal group （P~0. 05, P~0. 01）, such as whole blood viscosity, red blood cell （RBC）, red protein concentration （Hb）, hematocrit （HCT） ,erythrocyte sedimentation rate （ESR）, blood glucose （GLu）, triglycerides （TG）, cholesterol （Cho）, total protein （TP） ,albumin （A） and globulin （G） were significantly declined. The indexes of D-dimer （DD） and fibrinogen （FIB） signifi- cantly increased,the indexes of prothrombin time （PT） and activated partialthrombo plastin time （APTT） decreased. But, there was no significant difference in plasma viscosity between observation group and control group （P~0.05）. Conclusion The changes of hemorheology in patients with deficiency cold of spleen stomach after secondary thoracic obstruction may be mainly due to RBC and HCT decreased, which are usually caused by maldigestion and malabsorption. Hypercoagulale state is due to the fact that hypoxia,ischemic in organ tissue and cold injury can result in activation of coagulation system.