恶性血液病人的血液流变学改变  

HEMORRHEOLOGICAL CHANGES IN PATIENTS WITH MALIGNANT HEMATOLOGICAL DISORDERS

作　　者：杨平地[1] 沈素芸[1] 吴婉堃 范家骏 

机构地区：[1]西京医院,西安710032 [2]403所 [3]物理教研室

出　　处：《中国实验血液学杂志》1994年第3期293-297,共5页Journal of Experimental Hematology

摘　　要：自1991.1至1992.1我们对33例恶性血液病患者进行了血液流变学检测,包括急性白血病15例,慢性粒细胞白血病7例,淋巴瘤11例。发现在恶性血液病中存在着明显的血液流变学异常,且不同疾病之间亦有差别。其异常主要表现在高切变速率下全血粘度下降,全血还原粘度上升,纤维蛋白原和红细胞内HbF含量增加,红细胞在外加切应力下变形性减低,红细胞聚集指数升高等。在逐项分析影响血液流变学多种参数后,可以看出,红细胞压积减低是使血液粘度下降的最重要的因素。应当注意的是除红细胞压积外,在恶性血液病中仍包含着诸多使血液粘度增高的因素,血浆因素中如纤维蛋白原增加,细胞成分因素中如红细胞变形性减低而聚集性增强,红细胞内HbF升高,使细胞内粘度增加。白细胞,特别在急性白血病,尽管其“计数”变化不大,但是其分化程度低,变形性差,对血液流变学表现出不可忽视的影响。这些材料提示,对于呈现“低粘”的恶性血液病,特别是急性白血病,应进一步对流变学的各个参数逐项分析,因为其中潜伏着诸多引起血液粘度增高的因素,这对我们观察临床上经常出现的肺水肿、栓塞或呼吸窘迫综合征均有指导意义。Hemorrheological examinations were performed in 33 male patients with malignant hematological disorders. All of patients, including AL 15 cases, CML 7 cases and LM 11 cases, had remarkable rheological changes; viscosity of whole blood decreased, the content of plasma fibrinogen and quantity of HbF in red cell increased, red cell deformability decreased, but RBC aggregation increased. Since many patients had anemia, their Hct and blood viscosity were lower, but if we analysed each factor affecting viscosity, variable factors could cause increase of blood viscosity. This results could be helpful in observation and analysis of pulmonary edema, thrombosis and ARDS in malignant hematological disorders.

关 键 词：恶性血液病 血液流变学 全血粘度 纤维蛋白原 

分 类 号：R733[医药卫生—肿瘤]