真性红细胞增多症的微循环研究  

Study of Microcirculation on Polycythemia Vera

作　　者：赵国忠[1] 张大龙[2] 

机构地区：[1]中国医学科学院血液学研究所,邮政编码天津300020 [2]广东省深圳市人民医院

出　　处：《微循环学杂志》1996年第1期27-28,共2页Chinese Journal of Microcirculation

摘　　要：通过首次对109例真性红细胞增多症进行微循环系列检测探讨其发病机理,结果发现:患者甲襞微血管袢呈"等扩型"者78例(71.6%),血色暗红、血细胞浓密、流速减慢者88例(80.7%),袢顶出血者70例(64.8%);球结膜微循环观察41例患者,其中37例(90.2%)呈"密网状",微血管口径扩张以细静脉和毛细血管为著,25例(60.9%)口径粗细不匀,37例血液流态类似甲襞所见,20例(48.8%)可见微池;指腹皮肤血细胞灌流量增加脉动幅度减低。结果提示:RBC升高是上述改变的关键。RBC升高使ηb升高,外周阻力增大,心脏负荷增大、功能受损,三者互为因果、相互促进,形成恶性循环,影响组织供氧和代谢,构成临床表现的病理生理基础。The investigative series recruits of microeireulation on 109 patients with polycythemia vera(PV) were reported by composer firstly. It was found that both of caliber of arterial and venule limbs of nail/old capillary loops were dilated almost equally in 78(71.6%) cases, the dense RBC, dark blood and slowly blood flow velocity were seen in 88(80.70%) cases, the petechiae round the top of capillary loops were seen in 70(64.8%) cases; The mieroeirculation of bulbar eonjunetiva was observed in 41 patients, it was showed that the terminal capillary network was densely in 37(90.2%) cases and the venules and capillaries were delated more obviously than that of arterioles, in 25 (60.9%) cases the caliber of microvessels were not uniform or suddenly interrupted and/or disappeared, the blood flow state was simillar as seen in the nailfold capillary loops, mieropools were noticed in 20(48.8%) cases of subjects in venules as well as oapillaries; the blood cell perfusion volume in the skin of fingertips was elevated but te pulse amplitude was diminished. It was believed that the increased RBC count is the key factor for the changes as mentiened abouv. The rib increasing due to the increased RBC, the peripheral resistance rised as well and the load of heart was added, the three of them were affected and promoted on each orther and made up a vicious circle. The oxygen supply to the tissues and further more the metabolism are damaged, and make up the pathogasis bases of the PV's clinical phenomina.

关 键 词：红细胞增多症 微循环 病理 

分 类 号：R555.102[医药卫生—血液循环系统疾病]