Relation between extent of coronary artery disease and blood viscosity.

Blood viscosity (shear rate 100/s) and its major determinants (packed cell volume, plasma fibrinogen concentration, and plasma viscosity) were measured before coronary angiography in 50 men aged 30-55 and related to the extent of coronary artery disease. Twenty-six men had extensive disease (stenosis of two or three major coronary vessels), and 24 had either stenosis of one vessel or no stenosis. The 26 men with extensive disease had significantly higher mean blood viscosity than those with mild or no disease and 25 healthy controls (p less than 0.001). The increased viscosity was due partly to a higher packed cell volume and partly to a higher fibrinogen concentration; plasma viscosity was not significantly increased. These differences could not be explained by smoking history. These results suggest an association between increased blood viscosity and extensive coronary artery disease in men, which merits further investigation.     

Hematocrit and Coronary Heart Disease

Hematocrit values of patients with acute myocardial infarction have been reported by some workers to be higher than those found in controls; this has been denied by others. In these reported studies important postural, postprandial, age and stress effects have not been considered. In the present investigation hematocrits of healthy and coronary subjects were determined under the same “standard basal” conditions, in the morning hours, fasting or after a light breakfast, and in sitting position; patients studied had no acute illness or distress. A mean hematocrit of 49.1 ± 2.4% was observed in 66 men with chronic coronary disease and of 46.8 ± 3.2% in 68 healthy controls of the same age and sex, the difference being highly significant. The increased hematocrit and plasma viscosity in coronary patients creates significantly higher whole blood viscosity than that observed in healthy controls. This hemodynamic factor may be responsible for the development of clinical symptoms of coronary heart disease and possibly of the basic vascular disease itself.     

Risk factors evaluation in some cardiovascular diseases

Cardiovascular risk factors are associated with limitations of blood fluidity. Rheological behaviour of blood in transient flow may result from the internal organization, which in turn depends upon many parameters, which may be considered as possible elements of a profiling algorithm for diagnostic and prognostic values in various pathophysiological states. This study was designed to investigate haemorheological parameters in patients being treated for hypertension, coronary heart disease and myocardial infarct. On the basis of plasma viscosity, whole blood viscosity, haematocrit, red cell aggregation and red cell deformation, the risk was evaluated. In cases of hypertension there was a significant rise in plasma viscosity, whole blood viscosity, red cell aggregation and a fall in red cell deformability. In cases of coronary disease, plasma viscosity and red cell aggregation was increased, while in patients with myocardial infarcts, where the degree of severity is greater it was found that there was a significant rise in both plasma and whole blood viscosity. Haematocrit values were unaffected in all three groups.     

血浆及外周血中性粒细胞内髓过氧化物酶水平在冠心病临床诊断中的意义

目的:研究冠心病患者外周循环血中性粒细胞中髓过氧化物酶指数(MPXI)和血浆中髓过氧化物酶(MPO)浓度的改变及两者间相关性,探讨两者在冠心病临床诊断中的意义。方法:随机选取冠心病患者55例,按病情严重程度分为急性冠脉综征(ACS)组35例[包括不稳定心绞痛(UAP)组21例和急性心肌梗死(AMI)组14例]和稳定心绞痛(SAP)组20例,同时随机选取健康体检人员60例为正常对照组;采用ADVIA2120全自动血细胞分析仪检测MPXI,取血浆用ELISA法检测血浆MPO浓度。结果:ACS组MPXI(6.31±4.24)显著高于SAP组(3.38±2.14)和对照组(2.78±2.12),差异有统计学意义(P<0.05);SAP组MPXI高于正常对照组,差异无统计学意义(P>0.05)。ACS组血浆中MPO(1204.07±838.61 pmol/L)显著高于SAP组(755.97±426.23 pmol/L)和对照组(290.45±99.87 pmol/L),差异有统计学意义(P<0.05);SAP组MPO显著高于正常对照组,差异有统计学意义(P<0.05)。SAP组MPXI与MPO无相关性(r=0.424,P>0.05),ACS组MPXI与MPO呈负相关(r=-0.536,P<0.05)。结论:MPXI和MPO在冠心病的诊断中有意义,MPXI与血浆中MPO在ACS组中呈负相关。     

血浆IIA分泌型磷脂酶A2水平与冠脉支架术后再狭窄关系

目的：测定稳定型冠心病患者支架植入术（percutanous coronary intervention,PCI）前血浆IIA分泌型磷脂酶A2（group IIA secretory phospholipase A2,IIA-sPLA2）的水平,以探讨该酶与冠脉支架术后再狭窄的可能关系。方法：稳定型冠心病行PCI患者63例,非冠心病患者39例,健康正常对照组42例,分别取外周静脉血测定血浆IIA-sPLA2酶浓度。PCI患者6个月后复查造影。结果：PCI患者术前该酶浓度显著高于正常对照组（P〈0．05）,支架内再狭窄率34．9％,再狭窄（restenosis,RS）患者支架术前该酶水平与无再狭窄患者该酶水平无统计学差异（P〉0．05）。结论：PCI患者术前血浆IIA-sPLA2酶浓度显著高于正常对照组,但可能与支架术后再狭窄无关。     

益心舒片联合美托洛尔对冠心病心绞痛患者心功能、血液流变学和血管内皮功能的影响

摘要 目的：探讨益心舒片联合美托洛尔对冠心病心绞痛患者心功能、血液流变学和血管内皮功能的影响。方法：纳入南京市中心医院2020年7月~2022年8月期间收治的冠心病心绞痛患者126例。采用随机数字表法分为对照组（n=63,接受美托洛尔治疗）和研究组（n=63,对照组基础上接受益心舒片治疗）。对比两组临床症状、心功能[左心室射血分数（LVEF）、心输出量（CO）、左室舒张末期内径（LVEDD）]、血液流变学[血浆黏度、全血高切黏度、全血低切黏度]和血管内皮功能[一氧化氮（NO）、内皮素-1（ET-1）]变化情况,同时观察两组不良反应发生率。结果：两组治疗12周后心绞痛发作次数减少,心绞痛持续时间缩短,研究组的改善幅度大于对照组（P<0.05）。两组治疗12周后CO、LVEF升高,LVEDD缩小,研究组的改善幅度大于对照组（P<0.05）。两组治疗12周后血浆黏度、全血高切黏度、全血低切黏度下降,研究组的改善幅度大于对照组（P<0.05）。两组治疗12周后ET-1下降,NO升高,研究组的改善幅度大于对照组（P<0.05）。对照组（4.76%）、研究组（6.35%）的不良反应发生率组间对比未见差异（P>0.05）。结论：益心舒片联合美托洛尔治疗冠心病心绞痛患者,可有效改善患者的血液流变学、心功能和血管内皮功能。     

血脂及血液流变学指标与突发性聋患者听力曲线类型的关系及其临床疗效的影响因素分析

摘要 目的：探究血脂及血液流变学指标与突发性聋（SSHL）患者听力曲线类型的关系,并分析临床疗效的影响因素。方法：选取2020年6月-2022年1月我院收治的103例SSHL患者设为SSHL组,另选取103例体检健康者设为健康组,分析两组血脂水平及血液流变学指标,比较不同听力曲线类型的SSHL患者血脂水平及血液流变学指标,Spearman相关分析血脂水平及血液流变学指标与SSHL患者听力曲线类型的关系,单因素和多因素Logistic回归模型分析SSHL患者临床疗效的影响因素。结果：与健康组比较,SSHL组总胆固醇（TC）、三酰甘油（TG）与全血高切、中切、低切粘度及血浆粘度明显增高（P＜0.05）,高密度脂蛋白-C（HDL-C）、低密度脂蛋白-C（LDL-C）差异比较无统计学意义（P＞0.05）。不同听力曲线类型的SSHL患者各项血脂指标比较差异均无统计学意义（P＞0.05）,不同听力曲线类型的SSHL患者各项血液流变学指标比较差异均有统计学意义（P＜0.05）,其中全聋型患者各项血液流变学指标显著高于低频下降型患者（P＜0.05）。血脂四项与SSHL听力曲线类型无显著相关性（P＞0.05）,而血液流变学指标与SSHL听力曲线类型显著相关（P<0.05）。治疗无效组患者双耳患病比例、听力曲线类型为全聋型比例、全血高切粘度、全血低切粘度、血浆粘度显著高于有效组患者（P＜0.05）,多因素Logistic分析结果显示：双耳患病、听力曲线类型为全聋型、血浆粘度增加为SSHL患者治疗无效的危险因素（P＜0.05）。结论：SSHL患者存在血脂及血液流变学异常,血液流变学与SSHL患者听力曲线类型和临床疗效有一定关系,其中双耳患病、全聋型、血浆粘度增加为SSHL患者治疗无效的危险因素,检测血脂和血液流变学对于SSHL诊治具有一定临床指导意义。     

The University of Manitoba Follow-up Study. A Prospective Investigation of Cardiovascular Disease: Part II. Build,Blood Pressure and Electrocardiographic Factors Possibly Associated with the Development of Coronary Heart Disease

The relationship of selected physical and electrocardiographic factors to the occurrence of coronary heart disease was examined in a cohort of 3983 healthy North American males followed up for 15 years. Variations in build or mean heart rate were not found to be related to the occurrence of coronary heart disease. The risk of coronary heart disease rose progressively as blood pressure increased. With readings of 160/95 mm. Hg or higher the risk was 1.77 times that of the population as a whole. Non-specific S-T and/or T wave changes in the electrocardiogram were associated with three times the risk of developing coronary heart disease. Individuals with the combination of a blood pressure of 160/95 mm. Hg and nonspecific T wave changes exhibited an augmented susceptibility to coronary heart disease, the risk being four times that of the whole population.     

Increase in fragmented phosphatidylcholine in blood plasma by oxidative stress

Oxidatively modified phospholipids with fragmented acyl chains have attracted much interest because of their proinflammatory activity and their potential involvement in atherosclerosis. They can be formed in vitro by free radical treatment of unsaturated phospholipids but it is not known under which conditions they accumulate in vivo. We assayed one species of fragmented phosphatidylcholine (PC) in human blood plasma by high performance liquid chromatography after precolumn derivatization with chloromethylanthracene. Structural analysis suggested that fragmented PC was a diacyl species with a palmitoyl group and a short oxidized residue, which most likely had four carbons. The concentration of fragmented PC was higher in elderly individuals with coronary heart disease than in young healthy controls. Smoking one cigarette acutely increased the concentration of fragmented PC in healthy adults. Fragmented PC also increased in the reperfusion period after treatment with cardiopulmonary bypass. The increase coincided with a surge of circulating neutrophils. In rats, the plasma concentration of fragmented PC was elevated by vitamin E deficiency and exposure to high oxygen.The data demonstrate that fragmented PC increases in blood plasma in response to various forms of oxidative stress.     

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。     

Evaluation of various hemorheological parameters in nonagenarians: evidence of an increase of fibrinogen

Cardiovascular disease is the most frequent cause of mortality in the elderly. A reduced microvascular blood flow associated with an increase in atherosclerosis might contribute to age related increases in the incidence of ischemic vascular disease. In order to evaluate the effect of age on some haemorheological parameters, blood and plasma viscosity and fibrinogen have been measured in 10 healthy elderly subjects, aged between 88 and 96 years, compared with 15 healthy young subjects (mean age 37 years). Elderly subjects showed a significant increase in plasma fibrinogen (p less than 0.0005) and a trend to an increase in plasma viscosity, whereas no difference was present in blood viscosity. These data confirm that aging is associated with a greater deal of thrombotic risk factors, the most important of which seems to be fibrinogen.     

H型高血压合并冠心病患者外周血中EMMPRIN、ADMA、Hcy、MMPs、Treg和Th17细胞水平检测

目的探讨H型高血压合并冠心病患者进行外周血各细胞因子水平检测的意义 方法选取陆军军医大学第一附属医院2015年5月至2018年2月收治的84例高血压合并冠心病患者作为观察组,其中H型高血压合并冠心病患者42例,归为H组,非H型高血压合并冠心病患者42例,归为非H组。随机选取同期我院收治的50例未合并高血压的冠心病患者为冠心病组,50例未合并冠心病的高血压患者为高血压组,45名健康成人为对照组。比较各组外周血EMMPRIN、MMPs、ADMA、Hcy、Treg、Th17细胞水平。采用方差分析和q检验进行统计学分析。 结果H组、非H组、冠心病组、高血压组患者外周血细胞外基质金属蛋白酶诱导因子（EMMPRIN）、基质金属蛋白酶（MMPs）、不对称二甲基精氨酸（ADMA）、Hcy、Th17细胞含量均高于对照组,Treg细胞含量与Treg/Th17的比值低于对照组（P?< 0.05）。H组患者血浆ADMA[（11.01±2.67）μmol/L]、Hcy含量[（17.78±3.32）μmol/L]高于非H组[（7.34±1.34）μmol/L、（6.26±2.17）μmol/L]、冠心病组[（9.11±2.28）μmol/?L、（7.39±3.09）μmol/L]、高血压组[（8.89±1.89）μmol/L、（6.89±2.38）μmol/L],差异有统计学意义（F?= 13.360,8.961,P?< 0.05）。而H组、非H组、冠心病组、高血压组患者外周血单核细胞表面的EMMPRIN表达量、MMPs、Treg细胞、Th17细胞含量与Treg/Th17的比值比较,差异均无统计学意义（P?> 0.05）。 结论H?型高血压合并冠心病患者外周血中EMMPRIN、MMPs、ADMA、Hcy水平升高,Treg/?Th17比值降低,其中ADMA的升高与H型高血压有相关性。     

Effects of gender and age on thixotropic properties of whole blood from healthy adult subjects

The thixotropic parameters of whole blood from 314 healthy subjects (154 women, 160 men) were measured with our modified method by Low shear 30 Rheometer and calculated according Huang's equation. This communication offered the reference range of thixotropic parameters from man and woman group. The results demonstrated that no significant differences existed in the plasma viscosity and fibrinogen between man and woman group. Man group had statistically higher values in HCT, yield stress (tau 0), Newtonian contribution of viscosity (mu), non-Newtonian contribution of viscosity (eta s--mu), apparent viscosity at 2.37 sec-1 (eta s), the equilibrium value of the structural parameter (A) and apparent kinetic rate constant of rouleaux breakdown (ARC) than those in woman group. The man and woman groups could be separately divided into five subgroups in terms of age. It was found that the levels of fibrinogen and plasma viscosity had a tendency of increasing with aging. In the old subgroup (greater than 60 years) of men and women HCT, tau v, mu, eta s, (eta s--mu) and A had significant lower values than those in young and middle-age subgroups. However, it was very interested that there were differences of ARC versus age between man group and woman group, i.e. ARC in the man subgroup II, IV had lower and the woman subgroup II, III, IV had higher values than their respective older subgroup did.     

Evaluation of various hemorheologic parameters in diabetes mellitus

It has been speculated that changes in intrinsic blood flow properties may contribute to the evolution of vascular complications in diabetes mellitus. To verify this hypothesis we measured hematocrit, fibrinogen, plasma and blood viscosity in 30 diabetic patients and in 25 healthy volunteers. Diabetics showed blood and plasma viscosity and fibrinogenemia higher than healthy subjects, although only plasma viscosity and fibrinogenemia were statistically significant (p less than 0.001). Moreover the diabetic patients with the highest HbAlc values had a significant increase in plasma viscosity compared with the patients with lower HbAlc values (p less than 0.001), despite a similar fibrinogenemia. This study confirms the presence of hemorheological changes in diabetes mellitus and shows a correlation between plasma viscosity and metabolic control.     

Blood viscosity responses to maximal exercise in endurance-trained and sedentary female subjects

To assess whether the rheological properties of blood might be altered by exercise, we measured whole blood viscosity, plasma viscosity, and its components in healthy female subjects before, immediately after, and 1 h after maximal upright exercise using the Bruce graded exercise protocol. Forty-seven female subjects (15 sedentary, 14 who ran 5-15 miles/wk, and 18 who ran greater than 50 miles/wk), ages 18-43 yr, were evaluated. Whole blood viscosity, measured with a cone and plate viscometer, increased an average of 12.6% with exercise. The increase was greater than can be attributed to the observed 8.9% increase in hematocrit alone due to a coincident increase in plasma protein concentration. However, plasma viscosity did not rise to the degree expected, likely due to a disproportionate observed loss of fibrinogen from the protein pool. These changes were independent of conditioning level or aerobic capacity. In this cross-sectional study, there appears to be no adaptive adjustment in females to physical conditioning that results in changes in blood viscosity.     

心可舒片联合盐酸地尔硫卓片治疗老年冠心病心绞痛的临床研究

摘要 目的：探讨心可舒片联合盐酸地尔硫卓片治疗老年冠心病心绞痛的临床疗效。方法：按照随机数字表法将湖北民族大学附属民大医院和武汉市江夏区第一人民医院2019年4月-2021年9月间收治的98例老年冠心病心绞痛患者分为对照组（盐酸地尔硫卓片治疗,n=49）和观察组（心可舒片联合盐酸地尔硫卓片治疗,n=49）。观察两组疗效、心绞痛缓解情况、血脂指标、血管内皮功能指标、心功能指标、血液流变学指标和不良反应发生情况。结果：观察组的临床总有效率高于对照组（P<0.05）。治疗4周后,与对照组相比,观察组的心绞痛发作频率减少,全血黏度、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、内皮素-1（ET-1）、血浆比黏度、左室收缩末期内径（LVESD）、红细胞压积更低,一氧化氮（NO）、高密度脂蛋白胆固醇（HDL-C）、左心室射血分数（LVEF）、心排血量（CO）更高,心绞痛发作持续时间缩短（P<0.05）。两组不良反应发生率对比无差异（P>0.05）。结论：心可舒片联合盐酸地尔硫卓片治疗老年冠心病心绞痛,可缓解心绞痛症状,改善血液流变学、心功能、血脂和血管内皮功能。     

Aerobic dive limit does not decline in an aging pinniped

Apneustic hunters such as diving mammals exploit body oxygen stores while submerged; therefore, any decline in oxygen handling at advanced life stages could critically impair foraging ability. We calculated the aerobic dive limit (cADL = 17.9 ± 4.4 min SD) from blood and muscle oxygen stores and published metabolic rates of Weddell seals within (9-16 years, n = 24) and beyond peak-reproductive age (17-27 years, n = 26), to investigate (1) senescent constraints in apneustic hunting, and (2) whether mass or age primarily determines oxygen stores and ADL in older seals. We compared cADL with behavioral ADL from 5,275 free-ranging dives (bADL = 24.0 ± 5.3 min, n = 18 females). We observed no changes in Weddell seal oxygen stores, its determinants, or in ADLs late in life. Oxygen stores were better predicted by mass than age, consistent with published findings for young adults. Hematological panels (n = 6) were consistent across mass and age, though hematocrit (females > males, 6% elevation) and mean corpuscular hemoglobin content (females < males, 8% reduction) varied by sex. Whole blood viscosity was decreased with increasing mass in females and was higher than in males overall (+18%). This was largely due to elevated hematocrit in females, although plasma viscosity also varied under some conditions. Females had higher blood volume and elevated blood oxygen stores (vol% body mass), which did not translate into significantly higher cADL (18.1 vs. 17.1 min for males). Neither cADL nor bADL were mass- or age-dependent.     

D- 二聚体、血流变学指标对结缔组织病患者诊疗价值研究

目的:探讨分析结缔组织病合并多器官损害患者D-二聚体(DD)、血流变学指标(血浆纤维蛋白原/血浆纤维蛋白降解产物FDP、全血黏度、血浆黏度)水平及指标变化对结缔组织病合并多器官损害患者病情活动期的诊疗价值。方法:本研究共纳入120例患者,其中活动组患者60例,病情缓解组患者60例,分别测定二组患者DD、血流变学指标水平,并采用t检验、灵敏度与特异度进行统计学分析与描述。结果:与缓解组比较,活动组DD、纤维蛋白降解产物(FDP)、全血黏度、血浆黏度、γ球蛋白、补体C4、ESR均具有统计学差异(P0.01),补体C3组间差异也具有统计学意义(P0.05)。各指标对于疾病活动性诊断的准确性,其DDFDP补体C3、C4γ-球蛋白血浆黏度全血黏度ESR。结论:结缔组织病合并多器官损害患者,其纤溶水平、微循环状态与疾病活动密切相关。     

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。     

Unexpected inverse relationship between insulin resistance and serum homocysteine in healthy subjects

Mild hyperhomocysteinemia has been established as a new independent risk factor for atherosclerosis and thrombosis. The metabolic syndrome of insulin resistance is associated with a high risk of coronary heart disease. Our objective was to determine if any relationship exists between the metabolic syndrome of insulin resistance in non-diabetic subjects and total serum homocysteine levels. Sixty-six healthy volunteers (33 males and 33 females) were selected from the population of Pilsen. Insulin resistance was measured by the Insulin Suppression Test using Octreotide. Steady-state plasma glucose concentrations at the end of the test period provided a quantitative measure of insulin resistance. Serum homocysteine level was estimated by high-pressure liquid chromatography. Serum folate and vitamin B12 were estimated using commercial kits on an Abbott IMx analyzer. All other laboratory tests were performed by standard methods in a routine biochemical laboratory. Subjects with the highest tertile of steady-state plasma glucose showed a significantly higher body mass index, blood pressure, fasting plasma triglyceride levels, plasminogen activator inhibitor-1 and lower HDL-cholesterol, i.e. an insulin resistance pattern. These subjects had significantly lower serum homocysteine levels compared with non-insulin resistant subjects. The negative association of insulin resistance and serum homocysteine was unexpected. The contribution of plasma folate levels to serum homocysteine levels and serum creatinine was significantly negative and positive, respectively.