老年肺心病血液流变学变化特点及其相关因素分析

目的：探讨老年慢性肺原性心脏病血液流变学变化特点及其与动脉血气分析的关系。方法：对６６例老年慢性肺心病、２２例非老年肺心病急性发作期及肺气肿急性发作期患者的血液流变学进行了测定并对其与血气分析、血红蛋白含量和红细胞计数进行了相关性分析。结果：老年慢性肺心病急性发作期全血粘度、血浆粘度及红细胞压积均高于肺气肿急性发作期，两者比较有显著性差异（均Ｐ＜００５以上）；与非老年肺心病比较无显著性差异（Ｐ＞００５）。发现全血高、低切变粘度与ＰａＯ２、Ｏ２ｓａｔ呈负相关关系（Ｐ＜００５），与红细胞计数、血红蛋白、红细胞压积及ＰａＣＯ２呈正相关（分别Ｐ＜００１、Ｐ＜００１、Ｐ＜００１、Ｐ＜００５）；血浆粘度与血红蛋白含量、红细胞计数呈正相关关系（Ｐ＜００１、Ｐ＜００５），与ＰａＯ２及ＰａＣＯ２无相关。结论：慢性肺心病急性发作期随病情进展血液粘稠度逐渐增加，缺氧和二氧化碳潴留是影响血液流变学的原因之一。

CLINICAL CHARACTERISTIC AND CORRELATION OF HEMORHEOLIGY AND BLOOD GAS LEVELS IN ACUTE ATTACKS OF THE ELDERLY COR PULMONALE

Objective:To investigate the clinical characteristic of hemorheology and the relationship between its and blood gas levels in acute attacks of the elderly cor pulmonale Methods: Hemorheologic levels were studied in the acute attacks of the elderly cor pulmonale of 66 cases, non-gerontal patient of 22 cases and emphysema The correlation between hemorheologic levels and blood gas levels, hemoglobin and red blood cell count were studied Results: The levels of blood and plasma viscosity, hematocrit in acute attacks of the elderly cor pulmonale increased markedly, and there was significant difference with group of emphysema ( P <0 05), it was no significant difference with non-gerontal patiant ( P >0 05) There was a negative correlation between the blood viscosity and PaO 2, O 2sat ( P <0 05), and a positive correlation between blood viscosity and red blood cell count, hemoglobin, hematocrit and PaCO 2 ( P <0 01, <0 01, <0 01, <0 05) There was a positive correlation with plasma viscosity and hemoglobin, red blood cell count( P<0 01,P <0 05) Conclusion:Hemorheologic levels in acute attacks of cor pulmonale increased gradually to follow diseases advancing Hypoxemia and hypercapnia are one of the important causes to effect the hemorheology