急性脑梗塞患者红细胞流变特性及其药物干预效应临床研究  

The Rheologic Properties of Erythrocyte and Therapeutic Effects of Drugs in Patients with Acute Cerebral Infarction

作　　者：张孝超 王鹏[1,2,3] 王景周[1,2,3] 陈曼娥[1,2,3] 

机构地区：[1]解放军第17医院内科 [2]兰州军区兰州总医院心内科 [3]第三军医大学大坪医院神经内科

出　　处：《西北国防医学杂志》1998年第2期9-11,共3页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的：探讨急性脑梗塞（ＡＣＩ）患者的红细胞流变特性及药物干预治疗的效应。方法：采用激光衍射法等方法测定了４６例ＡＣＩ患者的红细胞流变学指标，与２２例正常人对照；并随机将患者分为己酮可可碱（ＰＴＸ）组和低分子右旋糖酐（ＬＭＤ）＋乙酰水杨酸（ＡＳＡ）组对照干预治疗。结果：脑梗塞患者红细胞流变学指标显著异常，且红细胞变形指数（ＤＩ）与患者神经功能缺损评分（ＮＤＳ）呈显著负相关。用药后两组红细胞流变学指标及ＮＤＳ均有显著改善。随用药时间的延长，ＰＴＸ组改善红细胞变形性（ＥＤ）和减轻患者ＮＤＳ优于ＬＭＤ＋ＡＳＡ联合组。结论：红细胞流变特性异常尤其ＥＤ降低是脑梗塞病理生理过程中的重要因素之一，并对患者的病情发展和预后具有重要影响。Purpose:To investigate the rheologic properties of erythrocyte and the therapeutic effects of drugs in patients with acute cerebral infarction(ACI).Methods:The rheologic parameters of erythrocyte were measured in 46 ACI patients with ektacytometry and viscometery,while 22 normal persons served as controls.The patients were randomly divided into two groups:one treated with pentoxifylline (PTX) and the other treated with low molecular dextran and acetylsalicylic acid(LMD+ASA). Results: The erythrocyte deformability (ED),oxygen dilivery index(OD) and mean corpuscular hemoglobin concentration(MCHC) of ACI patients decreased significantly;their erythrocyte aggregation(EA),blood viscosity(BV) and mean corpuscular volume(MCV) increased obviously,and the erythrocyte deformable index(DI) was reversely correlated with the nurologic deficit scores(NDS) of the patients. Both the rheologic properties of erythrocyte and NDS improved markedly in all two groups after medication. Along with the medication, patientsED and NDS improved more markedly in TPX group than that in LMD+ASA group.Conclusion:The abnormal rheologic properties of erythrocyte,especially the decreasing of ED is one of the important factors in the pathophysiologic process of cerebral infarction, and it plays a great role in the process and prognosis of this disease.PTX would be one of the effective medicines treating ACI.

关 键 词：脑梗塞 红细胞流变学 己酮可可碱 治疗 

分 类 号：R743.33[医药卫生—神经病学与精神病学]