蝮蛇抗栓酶治疗高粘滞血症的血流变学研究（附47例分析）

本文报道采用蝮蛇抗栓酶治疗血液粘度异常以上的高粘滞血症４７例,以复方丹参对照观察,两组治疗１～２疗程后,复查血液粘度恢复正常者,抗栓酶治疗组占６８％,复方丹参治疗组占６０％;两种药物对降低全血粘度,血球压积,加快红细胞电泳均有明显作用;抗栓酶对降低纤维蛋白原和男性的全血粘度较复方丹参作用更显著,是治疗高粘滞血症一种较理想的药物,也可作为心脑缺血性血管疾病的预防治疗。     

蝮蛇抗栓酶,丹参注射液对高粘状态血液流变学影响的对比观察

本文应用蝮蛇抗栓酶(清栓酶)和丹参注射液对高血压、冠心病、脑动脉硬化并有高粘状态84例进行治疗,其中清栓酶组50例;丹参组34例。检测血球压积,全血比粘度、全血还原粘度、血浆比粘度、红细胞电泳、纤维蛋白原、血沉等7项血液流变学指标,并进行治疗前后对比观察。经统计学处理后发现抗栓酶组的治疗效果明显优于丹参组(P<0.005)。抗栓酶有大幅度降低纤维蛋白原的作用。所以蝮蛇抗栓酶是目前应用于血栓病。血液高粘滞血症HVS等病症较为理想的药物。     

锰对作业工人血液流变学的影响及清栓酶的疗效观察

本文对１０３例锰作业工人测定了血液流变学中的七项指标,结果表明：全血粘度（高切、低切）、血浆粘度、红细胞压积、纤维蛋白原、红细胞电泳、血小板粘附、血沉等项指标,均明显高于正常对照组（Ｐ＜０．０１）,证实锰作业工人普遍存在高粘滞血症,为临床治疗锰中毒开辟新的途径提供了依据。对其中的５２例锰中毒（包括症状较重的观察对象）,用清栓酶治疗后,复查其七项指标与治疗前比较,均有明显下降（Ｐ＜０．０１）,其症状与体征得以改善,进一步说明清栓酶是治疗锰中毒的理想药物之一。     

高粘滞综合征及其治疗近展简述

高粘滞综合征及其治疗近展简述天津运输工程学院门诊部（解放军东局子医院）郑盛群高粘滞血症,也你高粘滞综合征,简你：ＨＶＳ。是一个病理生理的综合概念,它是由一个或几个血液粘滞因素升高所致的综合症。血液粘滞因素包括：血浆粘度、红细胞聚集、红细胞内粘度和刚性...     

浙江产蝮蛇毒(Agkistrodon halys pallas venom)凝血酶样酶的性质及其对血凝和血脂的影响

从浙江产蝮蛇毒中分离出一种凝血酶样酶,该酶能明显地延长全血凝固时间,白陶土部分凝血活酶时间(KPTT),并降低了血浆中的纤维蛋白原水平,同时全血的比粘度和血浆的比粘度及血清中的胆固醇和β脂蛋白均有所下降.该酶不激活凝血因子ⅩⅢ.     

蝮蛇抗栓酶和酚妥拉明治疗肺心病疗效观察

１３例肺心病急性发作期的患者,应用蝮蛇抗栓酶和酚妥拉明治疗,分别在一个疗程开始前和结束后观察心率、ＰａＯ２、ＰａＣＯ２、全血比粘度,血浆比粘度、红细胞压积、纤维蛋白原。其结果是心率减慢、ＰａＯ２增高,ＰａＣＯ２降低,全血比粘度、血浆比粘度、红细胞压积,纤维蛋白原均降低,经ｔ检验Ｐ＜０．０１。症状明显改善,心肺功能好转。文章对蝮蛇抗栓酶和酚妥拉明的作用机理进行了分析和探讨。     

清栓酶作用机理研究

本文应用动物DIC模型进行清栓酶作用机理的实验研究,观察指标包括应用清栓酶前后血浆中6-K-PGF_2α,TXB_2,全血粘度等的变化以及脑、肺、肾等脏器的不同病理改变。实验结果表明,A组血中TXB_2增高明显,全血粘度增高,病理改变以血栓形成、血小板聚集,血管内纤维蛋白原沉积为主,B组血中6-K-PGF_1α增高明显、全血粘度下降,病理改变以血管扩张为著,程度淤血,未见透明血栓。从而推测清栓酶之所以具有去纤、溶栓、扩血管、改善微循环等作用与血中前列腺毒的增高等因素有关。     

锰对作业工人血液流变学的影响及清检酶的疗效观察

本文对１０３例锰作业工人测定了血液流变学中的七项指标,结果表明;全血粘度、血浆粘度、红细胞压积、纤维蛋白原、红细胞电泳、血小板粘附、血沉等项指标,均明显高于正常对照组,证实锰作业工人普遍存在高粘滞血症,为临床治疗锰中毒开辟新的途径提供了依据。     

80例TIA病人的血液流变学分析

目的探讨ＴＩＡ病人的血液流变学改变。方法８０例ＴＩＡ病人均在末次发作后２４ｈ内静脉抽血进行血液流变学测定,并与对照组进行比较。结果ＴＩＡ组病人的红细胞压积、全血高切粘度、全血低切粘度、全血还原高切粘度、全血还原低切粘度、血浆粘度及红细胞聚集性各指标均明显增高,与正常对照组比较有显著性差异。结论血液粘度的增高是引起短暂性脑缺血发作的发病机制之一。     

东菱精纯克栓酶对高粘血症患者血流变的影响

目的观察东菱精纯克栓酶对高粘血症患者血液流变学的影响,并探讨其影响机制。方法用东菱精纯克栓酶治疗２８例高粘血症患者。结果东菱精纯克栓酶能明显地降低血粘度,表现为全血粘度、血浆比粘度、全血还原粘度及纤维蛋白原水平降低。结论东菱精纯克栓酶通过降低高粘血症患者血粘度而起治疗作用。     

Effect of high osmotic media on blood viscosity and red blood cell deformability

Effects of high osmotic media on the shape and deformability of RBC were examined for determining increasing factors of blood viscosity. Dog blood and Urographin (a hypertonic contrast medium) were used; the plasma osmolality was changed by Urografin suspended in blood. The viscosity was measured for normal RBC and glutaraldehyde-treated RBC suspensions with a cell volume concentration. The RBC deformability was evaluated from the difference in viscosity between the two suspensions. It was shown that normal RBC suspension increased the viscosity with increase in osmolality at high shear rate; hardened RBC suspension decreased the viscosity with increase in osmolality. It was concluded that the RBC deformability decreased with increasing osmolality.     

不同海拔地区藏族就诊人群血脂、血液黏度、HCY水平与心血管疾病的相关性研究

目的:探讨不同海拔地区藏族就诊人群血脂、血液黏度、HCY水平与心血管疾病的相关性。方法:采用回顾性分析的方法,将328例来自不同海拔地区的藏族就诊患者为三组,高海拔组(纳入99例),中海拔(纳入120例)和低海拔组(纳入109例),比较不同海拔高度组患者血压、血脂、血液黏度、HCY、疾病类型的差异,采用多元Logistic回归模型分析藏族就诊人群心血管疾病发病的影响因素。结果:不同海拔组收缩压、舒张压、血清HCY、TC、TG、HDL-C、LDL-C水平、全血黏度低切、中切、高切、血浆黏度和红细胞压积比较差异均有统计学意义(P0.05),随着海拔升高,收缩压、舒张压、血清HCY、TC、TG以及LDL-C、全血黏度低切、中切、高切、血浆黏度和红细胞压积水平显著升高(P0.05),而血清HDL-C水平显著下降。41.8%(137/328)的就诊者至少患有一种心血管疾病,和非心血管组比较,心血管疾病组年龄明显偏高,居住主要分布在中度及高度海拔地区,合并高血糖、高血脂、高HCY的比例均明显较高,差异均有统计学意义(P0.05)。年龄、海拔、高血糖、高血脂、高HCY均和心血管疾病相关(r=-0.230~0.334,P0.05)。多元Logistic回归分析显示年龄、居住地海拔、HCY水平、全血低切粘度、TG水平、LDL-C等因素是心血管疾病发生的危险因素,HDL-C是保护因素。结论:来自不同海拔地区的就诊人群在血压、血脂、血液黏度、HCY水平以及心血管疾病患者占比不同。年龄、居住地海拔、HCY水平、血液黏度、血脂水平等增加可能使高原藏族人群心血管疾病发生风险增加。     

肠淋巴液引流对失血性休克大鼠红细胞流变性的影响

目的:观察肠淋巴液引流对失血性休克大鼠红细胞流变性指标以及血液黏度的作用。方法:Wistar雄性大鼠均分为假休克组、休克组(复制失血性休克模型)、引流组(复制失血性休克模型,自低血压1 h引流休克肠淋巴液)。在低血压3 h或相应时间,经腹主动脉取血,检测红细胞参数、红细胞电泳、红细胞沉降率(ESR)以及血液黏度,计算红细胞聚集指数、红细胞变形指数。结果:与假休克组比较,休克组红细胞数量、红细胞比积(HCT)、血红蛋白(Hb)、平均红细胞血红蛋白浓度(MCHC)、红细胞电泳率与迁移率、红细胞变形指数、全血黏度、全血低切与高切相对黏度和还原黏度显著降低,休克组平均红细胞体积、红细胞电泳时间、ESR、血沉方程K值与校正K值、红细胞聚集性指数、血浆黏度显著升高;引流组MCHC、红细胞电泳率与迁移率、全血黏度、全血低切与高切还原黏度均显著降低,引流组红细胞体积分布宽度(RDW-SD)显著增加。同时,引流组HCT、RDW-SD、红细胞变形指数、全血黏度、全血低切与高切相对黏度显著高于休克组;ESR、血沉方程K值与校正K值、红细胞聚集性指数、血浆黏度显著低于休克组。结论:休克肠淋巴液引流可改善失血性休克大鼠红细胞流变行为,从而改善血液流变性。     

In silico biophysics and hemorheology of blood hyperviscosity syndrome

Hyperviscosity syndrome (HVS) is characterized by an increase of the blood viscosity by up to seven times the normal blood viscosity, resulting in disturbances to the circulation in the vasculature system. HVS is commonly associated with an increase of large plasma proteins and abnormalities in the properties of red blood cells, such as cell interactions, cell stiffness, and increased hematocrit. Here, we perform a systematic study of the effect of each biophysical factor on the viscosity of blood by employing the dissipative particle dynamic method. Our in silico platform enables manipulation of each parameter in isolation, providing a unique scheme to quantify and accurately investigate the role of each factor in increasing the blood viscosity. To study the effect of these four factors independently, each factor was elevated more than its values for a healthy blood while the other factors remained constant, and viscosity measurement was performed for different hematocrits and flow rates. Although all four factors were found to increase the overall blood viscosity, these increases were highly dependent on the hematocrit and the flow rates imposed. The effect of cell aggregation and cell concentration on blood viscosity were predominantly observed at low shear rates, in contrast to the more magnified role of cell rigidity and plasma viscosity at high shear rates. Additionally, cell-related factors increase the whole blood viscosity at high hematocrits compared with the relative role of plasma-related factors at lower hematocrits. Our results, mapped onto the flow rates and hematocrits along the circulatory system, provide a correlation to underpinning mechanisms for HVS findings in different blood vessels.     

Pharmacological concentrations of arginine influence human whole blood viscosity independent of nitric oxide synthase activity in vitro

l-Arginine, the natural precursor of NO, is infused in patients to restore endothelial function. Concentrations up to 7.5 mM l-arginine have been measured after parenteral administration. We investigated whether such high concentrations of amino acids influence blood viscosity in vitro. Incubation of whole blood from healthy volunteers with l-arginine, d-arginine, which has no effect on stereospecific NO synthases (NOS), the NOS substrate L-AME, the NOS inhibitor L-NNA, the amino acids l-lysine and l-glutamic acid, and finally NaCl dose-dependently decreased (up to 30% at 10(-2) M) low shear viscosity, which is primarily determined by erythrocyte aggregation. In contrast, the lipophilic NOS inhibitor L-NAME had no effect on low shear viscosity. All molecules failed to influence high shear viscosity, which is primarily determined by red cell deformability, and the erythrocyte shape remained unaltered. We conclude that high concentrations amino acids may decrease blood viscosity at low shear rate independent of NOS activity. This effect may contribute to the improved blood flow after intravascular administration of l-arginine.     

Cardiac mechanoenergetic cost of elevated plasma viscosity after moderate hemodilution

The purpose of this study was to investigate how plasma viscosity affects cardiac and vascular function during moderate hemodilution. Twelve anesthetized hamsters were hemodiluted by 40% of blood volume with two different viscosity plasma expanders. Experimental groups were based on the plasma expander viscosity, namely: high viscosity plasma expander (HVPE, 6.3 mPa?·?s) and low viscosity plasma expander (LVPE, 2.2 mPa?·?s). Left ventricular (LV) function was intracardiacally measured with a high temporal resolution miniaturized conductance catheter and concurrent pressure-volume results were used to calculate different LV indices. Independently of the plasma expander, hemodilution decreased hematocrit to 28% in both groups. LVPE hemodilution reduced whole blood viscosity by 40% without changing plasma viscosity, while HVPE hemodilution reduced whole blood viscosity by 23% and almost doubled plasma viscosity relative to baseline. High viscosity plasma expander hemodilution significantly increased cardiac output, stroke volume and stroke work compared to baseline, whereas LVPE hemodilution did not. Furthermore, an increase in plasma viscosity during moderate hemodilution produced a higher energy transfer per unit volume of ejected blood. Systemic vascular resistance decreased after hemodilution in both groups. Counter-intuitively, HVPE hemodilution showed lower vascular resistance and vascular hindrance than LVPE hemodilution. This result suggests that geometrical changes in the circulatory system are induced by the increase in plasma viscosity. In conclusion, an increase in plasma viscosity after moderate hemodilution directly influenced cardiac and vascular function by maintaining hydraulic power and reducing systemic vascular resistance through vasodilation.     

血栓通注射液联合阿托伐他汀对急性脑梗死患者血脂和血液流变学的影响

目的:研究阿托伐他汀片与血栓通注射液联合治疗对脑梗死患者血脂及血液流变学的影响。方法:选取我院从2012年2月到2014年2月收治的急性脑梗死患者100例,分成两组,每组各50例。对照组静脉滴注血栓通注射液,试验组静脉滴注血栓通注射液加口服阿托伐他汀片治疗。14天后观察两个组的治疗效果,并且进行血脂(TC、TG、LDL-C、HDL-C)、血液流变学(血浆粘度、全血高切粘度、全血低切粘度、全血还原黏度、纤维蛋白原、细胞刚性指数)等指标的检测,以及疗效及不良反应情况。结果:治疗后试验组TC、TG、LDL-C低于对照组,HDL-C高于对照组,且具有统计学意义(P0.05)。治疗后,试验组血浆粘度、全血高切粘度、全血低切粘度、全血还原黏度、纤维蛋白原、细胞刚性指数均低于对照组,且具有统计学意义(P0.05)。试验组总有效率为88.0%(44/50),高于对照组的66.0%(33/50)(P0.05)。试验组发生不良反应发生率与对照组比较无统计学意义(P0.05)。结论:阿托伐他汀片联合血栓通注射液对于脑梗死患者的血脂和血液流变学的影响疗效显著,且具有明显的降脂效果。     

大功率微波急性辐照对血液流变特性的影响

用２．４５ＧＨｚ的连续微波对大白兔在体血液和人离体血液进行急性大剂量辐照,对辐照前和辐照后的血液粘度,粘弹性,血小板聚集性,红细胞脆性进行了实验研究,实验结果表明：微波辐照后兔血的粘度和粘弹性值降低,人血的粘度在低切变率下降低,在较高的切变率下升高;兔血小板聚集功能降低,二相聚集的解聚率增大;红细胞的脆性增大。     

大功率微波急性辐照对血液流变特性的影响

用２．４５ＧＨｚ的连续微波对大白兔在体血液和人离体血液进行急性大剂量辐照,对辐照前和辐照后的血液粘度,粘弹性,血小板聚集性,红细胞脆性进行了实验研究,实验结果表明：微波辐照后兔血的粘度和粘弹性值降低,人血的粘度在低切变率下降低,在较高的切变率下升高;兔血小板聚集功能降低,二相聚集的解聚率增大;红细胞的脆性增大。