Sargento L, Zabala L, Saldanha C, Souza-Ramalho P, Martins-Silva J
Instituto Bioquímica e Quimica Fisiológica, Fac. Medicina Lisboa, Portugal.
Clin Hemorheol Microcirc. 1999;20(2):77-84.
Sodium fluorescein angiography is a widely used technology in ophthalmology, which allows us to visualise the chorioretinal microcirculation. Previous reports showed a prolongation of the retinal circulation time along with erythrocyte hyperaggregation and a decrease of erythrocyte acetylcholinesterase activity and a possible interference with the erythrocyte's membrane fluidity. The aim of the present work is to investigate the influence of sodium fluorescein on the hemorheological profile of a group of 23 non-insulin dependent diabetes mellitus (NIDDM) patients undergoing routine retinal angiography. Thirty minutes after the endovenous administration of the fluorescein there was: (I) an increase of whole blood viscosity (p = 0.015), erythrocyte elongation index (EEI, p < 0.05), whole blood pH (p < 0.001), methemoglobin (p < 0.001) and carboxyhemoglobin (p < 0.001) concentrations; (II) no variation of plasma osmolality and erythrocyte aggregation index (EAI); (III) a decrease of the erythrocyte acetylcholinesterase activity, p < 001; (IV) no variation in membrane lipid fluidity, although 1,6-diphenyl-1,3,5-hexatriene (DPH) correlated directly with the EEI, while 1,4-trimethyl-phenyl-1,3,5-hexatriene (TMA-DPH) and EAI correlated inversely, suggesting that the decreasing EEI (lower erythrocyte deformablity) might be associated with an increased rigidity of the external polar region and fluidification of the hydrophobic region of the erythrocyte membrane, with an increasing EAI. In conclusion, the endovenous administration of sodium fluorescein in NIDDM patients during the retinal angiography procedure interferes with the erythrocyte membrane and possibly with the microcirculatory blood flow.
荧光素钠血管造影术是眼科广泛应用的一项技术，它能使我们观察脉络膜视网膜微循环。既往报告显示视网膜循环时间延长，同时伴有红细胞高度聚集、红细胞乙酰胆碱酯酶活性降低以及对红细胞膜流动性可能产生的干扰。本研究的目的是调查荧光素钠对一组23例接受常规视网膜血管造影的非胰岛素依赖型糖尿病（NIDDM）患者血液流变学特征的影响。静脉注射荧光素30分钟后出现：（I）全血粘度升高（p = 0.015）、红细胞伸长指数（EEI，p < 0.05）、全血pH值（p < 0.001）、高铁血红蛋白（p < 0.001）和碳氧血红蛋白（p < 0.001）浓度升高；（II）血浆渗透压和红细胞聚集指数（EAI）无变化；（III）红细胞乙酰胆碱酯酶活性降低，p < 0.01；（IV）膜脂流动性无变化，尽管1,6 - 二苯基 - 1,3,5 - 己三烯（DPH）与EEI直接相关，而1,4 - 三甲基 - 苯基 - 1,3,5 - 己三烯（TMA - DPH）与EAI呈负相关，这表明EEI降低（红细胞变形性降低）可能与红细胞膜外部极性区域硬度增加和疏水区域流动性增加以及EAI增加有关。总之，在视网膜血管造影过程中给NIDDM患者静脉注射荧光素钠会干扰红细胞膜，并可能影响微循环血流。
