慢性肺源性心脏病血液流变学的特点和对治疗的意义  

Hemorheologic. characteristics of chronic cor pulmonale: sisnifieance in treatment.

作　　者：刘绍珊[1] 赵淑颖[1] 

机构地区：[1]北京友谊医院内科

出　　处：《中国危重病急救医学》1990年第4期209-211,256,共4页Chinese Critical Care Medicine

摘　　要：本文对31例肺心病患者进行血液流变学检查,有明显变化。全血比粘度与红血球压积之间有相关性。缺氧,二氧化碳潴留,高碳酸血症对血液粘滞度影响很大。肺心病伴呼吸衰竭时,缺氧,二氧化碳潴留,碳酸血症等明显,致使肺毛细血管扩张,血液淤滞,红血球粘附聚集,骨髓继发性红血球生成旺盛,肺内小血管血流不畅。又因细支气管感染,肺内小血管收缩,循环阻力加大,血液粘滞度升高,致使肺内灌注受到影响,肺里抗菌素高峰浓度比血浆内为低,为此影响疗效。本组有12例病人加用改善血液流变学治疗,以恢复肺内灌注,提高肺内抗菌素高峰浓度,从而加强了抗感染作用,川芎嗪效果良好。We studied the hemorheologic changes in 31 patients with cor pulmonale. Obvious changes were observed with a correlation between the viscosity of whole blood and hematocrit. Blood viscosity was greatly affected by hypoxia, CO_2 retention and hypereapnia, which were very obvious in cor pulmonale with respiratory failure. These changes caused capillary dilatation, blood stagnation, erythrocyte aggregation, secondary erythropoiesis in the bone marrow and the obstruction of blood flow in the small pulmonary vessels. Pulmonary perfusion was interfered by bronchiolar infection, contraction of the small pulmonary vessels, increased circulatory resistance and blood viscosity. As a result, the antibiotic peak concentration in the lungs was lower than the plasma, which influenced the therapeutic effect. Chuanxiong (Rhizoma Ligustici, a Chinese herb medicine)was used in 12 patients with good results. It was shown to improve the hemorheology with a restoration of pulmonary perfusion leading to an elevation of the antibiotic peak concentration in the lungs. Thus the action of antibiotics against infection was strengthened.

关 键 词：肺心病 血液流变学 川芎嗪 

分 类 号：R4[医药卫生—临床医学]