急性脑出血患者血液流变学指标变化的相关研究

发布时间：2018-03-07 20:54

本文选题：脑出血　切入点：急性　出处：《临床神经病学杂志》2017年01期 　论文类型：期刊论文

【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P0.01)。其中,高血压性脑出血组各指标均变化显著(均P0.01),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(P0.05~0.01)。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P0.05)。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(P0.05~0.01)。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P0.05)。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。
[Abstract]:Objective to investigate the changes and clinical value of hemorheological indexes in acute cerebral hemorrhage (AICH). Methods the hemorheological indexes of 100 patients with acute ICH (intracerebral hemorrhage group) were detected within 24 hours after the onset of ICH. The effects of history of hypertension, amount of blood loss and location of bleeding on hemorheological indexes were analyzed. Results compared with the normal control group, the whole blood viscosity of ICH group was compared with that of normal control group. Plasma viscosity and erythrocyte sedimentation rate (ESR) were increased, erythrocyte aggregation index, erythrocyte deformability index and hematocrit were all decreased (P 0.01). In hypertensive intracerebral hemorrhage group, all the indexes changed significantly (all P0.01A, the whole blood viscosity was only 200 s-1), and the erythrocyte aggregation index (RBC) was 50 slb ~ (-1) in the hypertensive intracerebral hemorrhage group, and the index of erythrocyte aggregation was higher than that in the control group (P < 0.05). The changes of hematocrit and erythrocyte sedimentation rate (ESR) were significantly different from those of non-hypertensive intracerebral hemorrhage patients (P 0.05). The whole blood viscosity and plasma viscosity of patients with intracerebral hemorrhage were all increased, the erythrocyte aggregation index was decreased, the difference was statistically significant (P 0.05), the difference was statistically significant (P < 0.01), and the whole blood viscosity and plasma viscosity of patients with intracerebral hemorrhage at different bleeding sites were 200 sm ~ (-1) and 1 s ~ (-1) respectively, and the plasma viscosity, the whole blood viscosity, the plasma viscosity of ICH patients were significantly higher than that of the control group (P < 0.05), but the difference was significant (P < 0.05). There were significant differences in erythrocyte aggregation index and erythrocyte sedimentation rate (all P 0.05). Conclusion Hemorheological abnormalities exist widely in patients with acute intracerebral hemorrhage, suggesting that the blood is concentrated, sticky and aggregated in acute cerebral hemorrhage. With the increase of hematoma volume, the hemorheology changes obviously, and the influence of different bleeding sites is also different.
【作者单位】：江苏大学附属医院神经内科;南京中医药大学流行病学教研室;
【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)
【分类号】：R743.34

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