摘要
目的探讨血液流变学指标在急性脑出血中的变化规律和临床价值。方法于发病24 h内检测100例急性期脑出血患者(脑出血组)的血液流变学指标,并与30名正常对照者(正常对照组)进行比较。分析高血压病史、出血量、出血部位对血液流变学指标的影响。结果与正常对照组比较,脑出血组全血黏度、血浆黏度和血沉均升高,红细胞聚集指数、红细胞变形指数和红细胞压积均降低(均P<0.01)。其中,高血压性脑出血组各指标均变化显著(均P<0.01),非高血压性脑出血组中仅全血黏度(200 s^(-1)和50 s^(-1))、红细胞聚集指数、红细胞压积和血沉变化有统计学意义(P<0.05~0.01)。与非高血压性脑出血患者比较,高血压性脑出血患者除血沉外,其余指标均变化显著(均P<0.05)。随着血肿量增加,脑出血患者全血黏度(200 s^(-1)和50 s^(-1))和血浆黏度均升高,红细胞聚集指数下降,差异有统计学意义(P<0.05~0.01)。不同出血部位脑出血患者200 s^(-1)和1 s^(-1)全血黏度、血浆黏度、红细胞聚集指数及血沉差异有统计学意义(均P<0.05)。结论急性脑出血患者广泛存在着血液流变学异常,提示脑出血急性期血液呈现浓、黏、聚、凝状态且合并高血压者变化显著。随着血肿量增加,血液流变学变化明显,不同出血部位影响也不同。
Objective To explore the change rule and clinical application value of hemorheologic indexes in patients with acute intracerebral hemorrhage （ICH）. Methods The hemorheology indexes of 100 acute ICH patients （ICH group） were detected within 24 h, and compared with 30 normal controls （normal control group）. The effect of hemorheology index on history of hypertension, hemorrhage quantity and the hemorrhage location were analyzed. Results Compared with those in normal control group, the indexes of whole blood viscosity, plasma viscosity and erythrocyte sedimentation rate were significantly increased and erythrocyte aggregation index, erythrocyte deformability index and hematocrit were significantly decreased in acute stage （all P 〈 0. 01 ）. Blood rheology indexes were changed significantly in hypertensive cerebral hemorrhage group （all P 〈 0. 01 ）, the whole blood viscosity （200 s- 1 and 50 s-1）, erythrocyte aggregation index, hematocrit and erythrocyte sedimentation rate in non-hypertensive cerebral hemorrhage group were changed significantly （ P 〈 0. 05 - 0. 01 ）. Compared with normal the non- hypertensive cerebral hemorrhage group, the whole blood rheology indexes except erythroate sedicmnt ation rate significantly erythrocyte sedimentation rate were significantly changed （P 〈 0. 05 ）. As the hemorrhage quantity increased in each groups, the whole blood viscosity （200 s-1 and 50 s-1） and plasma viscosity of cerebral hemorrhage patients were significantly increased, otherwise the erythrocyte aggregation index was significantly decreased （P 〈0. 05 -0.01 ）. There were statistical differences compared the indexes of whole blood viscosity （200 s-1 and 1s-1）, plasma viscosity, erythrocyte aggregation index and erythrocyte sedimentation rate among each groups of different hemorrhage locations in acute ICH patients （ all P 〈 0. 05）. Conclusions The blood of acute ICH patients shows a state of concentrated, sticky, aggregation and coagulation that severely affects the prognosis. The patients with hypertension and greater hematoma changed obviously, different hemorrhage location affected differently.
出处
《临床神经病学杂志》
CAS
北大核心
2017年第1期1-4,共4页
Journal of Clinical Neurology
基金
国家自然科学基金项目(81373512)
镇江市重点研发计划--社会发展重点(医卫)项目(SH2015024)
关键词
脑出血
急性
血液流变学
变化规律
intracerebral hemorrhage
acute
hemorheology
change rule
