直接测试红细胞流变性对老年脑梗死的临床意义探讨

目的　用两种方法做比较 ,探讨老年脑梗死患者治疗前、治疗后以及治愈后又复发时红细胞聚集指数和变形指数的变化 ,确定可靠的诊断依据。方法　分 3组 ,第 1组为实验组 ,确诊前未用过溶栓药和解聚药的初患者 ;第 2组为复发组 ,脑梗死治愈后近期头痛、头晕病情复发的病人 ;第 3组为正常对照组。均空腹抽血肝素抗凝 ,直接测试红细胞聚集指数 (Agg)和变形指数 (DEF) ,同时测试全血粘度高切值 (2 0 0s 1) ,低切值 (1s 1) ,常规法测试红细胞压积和纤维蛋白原 ,计算红细胞聚集指数(RE)和变形指数 (TK) ,实验组和复发组治疗后重复以上实验。结果　实验组和复发组直接测试的红细胞聚集指数 (Agg)明显高于对照组 (P <0 .0 5) ,与治疗后相比 (P <0 .0 5)有显著差异。间接计算的红细胞聚集指数 (RE)和变形指数 (TK)P >0 .0 5,无显著差异。结论　红细胞聚集指数Agg增高 ,红细胞变形指数降低是脑梗塞发生和复发的危险因素 ,Agg和DEF随病情变化 ,RE和TK随血粘度变化

The Reaserch on the Clinical Significance by Direct Measurement of Erythrocyte Rheology in Old Patients with Cerebral Infarction

Objective To study the changes of erythrocyte aggregation and deformity i ndexes prio to and after treatment for cerebral infarction and reinfarction in o ld patients with two different methods,for providing reliable diagnositic basis .Methods All subjects were divided into three groups.The pati e nts in the first group were not treated with thrombolytic and antcoagulating age nts before the measurements.In the second group,patients were those who had ce rebral reinfarction in the theraputic periods and had headaches and confusions. The third was the control.The blood samples were taken in fasting periods and a ntcoagulated with heparin. In all groups,erythrocyte aggregation indexes(AG G) and deformity indexes(DEF) were measured directly.The blood hypershearing f orce values(200s -1 ) and hyposhearing force values(1s -1 ) were meas u red with the cone-board viscositygraph.The erythrocyte heamocrit and fibrnogen were measured conventionaly and the erythrocyte aggregation indexes(RE)and def ormity indexes(TK) were calculated by the instrument.In the frst and second grou p the values were measured again after treatment.Results The AGG in the first and second groups were significantly higher than that in th e control( P <0.05),and the difference before and after treatment were signi ficant( P <0.05).But the differerces of RE and TK measured indirectly were n ot.Conclusion The increased AGG and decreased TK are the risks of cerebral infarction occurance and recurrence.AGG and DEF change as the changed disease seriosity.But the RE and TK as the blood viscosity.