Gertz M A, Kyle R A
Dysproteinemia Clinic, Mayo Clinic, Rochester, MN 55905, USA.
J Intensive Care Med. 1995 May-Jun;10(3):128-41. doi: 10.1177/088506669501000304.
Hyperviscosity syndrome is clinically manifested by oronasal bleeding, retinal hemorrhages, and variable neurological symptoms. It occurs when resistance to flow of blood increases sharply, resulting in impaired transit through the microcirculatory system. The most common cause of hyperviscosity is increased concentrations of gamma globulins, either monoclonal in malignant disease or polyclonal, usually seen with rheumatic disorders. Increased numbers of red blood cells, as in polycythemia vera, can result in viscous blood. Extreme increases in concentrations of mature and immature white blood cells can also produce hyperviscosity. Treatment with plasma exchange is required when the clinical syndrome is symptomatic. Although plasma exchange is not a completely benign procedure, it represents the most effective method of controlling hyperviscosity.
高黏滞综合征的临床表现为口鼻出血、视网膜出血以及各种神经症状。当血液流动阻力急剧增加，导致微循环系统内血液通过受阻时，就会发生高黏滞综合征。高黏滞最常见的原因是γ球蛋白浓度升高，在恶性疾病中为单克隆性升高，而在风湿性疾病中通常为多克隆性升高。红细胞数量增加，如真性红细胞增多症，可导致血液黏稠。成熟和未成熟白细胞浓度的极度升高也可产生高黏滞。当临床综合征出现症状时，需要进行血浆置换治疗。虽然血浆置换并非完全无害的操作，但它是控制高黏滞最有效的方法。
