Penco M, Romano S, Dagianti A, Tozzi-Ciancarelli M G, Dagianti A
Department of Internal Medicine, University of L'Aquila, Italy.
Clin Hemorheol Microcirc. 2000;22(2):153-9.
Experimental evidences underline that hemorheological alterations observed in acute myocardial infarction (AMI) are strictly involved in the decreased perfusion of the damaged area and in the extension of the necrotic regions. We have analyzed whole blood filterability as an index of erythrocyte deformability in 60 AMI patients compared with 30 patients with non-acute coronary artery disease and 52 healthy subjects. Nucleopore polycarbonate membranes with a pore diameter of 5 microm and a filtering pressure of -20 cm H2O were used. The results are expressed as the volume of whole blood filtered in 1 minute (index of filterability, IF). In normal subjects IF was 1.16 +/- 0.24. Among AMI patients IF was 0.70 +/- 0.30 at admission, 0.68 +/- 017 at day 10 and 0.78 +/- 0.14 at day 20. These values were significantly lower than those obtained in normal subjects and in patients with non-acute coronary artery disease. In addition, AMI patients treated with thrombolytic therapy showed, at admission, a significantly higher IF value than that obtained in patients who did not receive thrombolytic treatment (0.85 +/- 0.34 vs 0.60 +/- 0.22; p < 0.01). These results demonstrate an evident reduction of whole blood filterability in AMI patients that may be considered as an index of erythrocyte deformability. Thrombolytic therapy seems to have a positive effect on blood filterability and may produce beneficial effects through its therapeutical action other than the lysis of the coronary thrombus.
实验证据表明，急性心肌梗死（AMI）中观察到的血液流变学改变与受损区域灌注减少及坏死区域扩大密切相关。我们分析了60例AMI患者的全血过滤性，将其作为红细胞变形性的指标，并与30例非急性冠状动脉疾病患者及52例健康受试者进行比较。使用孔径为5微米、过滤压力为-20厘米水柱的核孔聚碳酸酯膜。结果以1分钟内过滤的全血体积表示（过滤性指数，IF）。正常受试者的IF为1.16±0.24。AMI患者入院时IF为0.70±0.30，第10天时为0.68±0.17，第20天时为0.78±0.14。这些值显著低于正常受试者及非急性冠状动脉疾病患者。此外，接受溶栓治疗的AMI患者入院时的IF值显著高于未接受溶栓治疗的患者（0.85±0.34对0.60±0.22；p<0.01）。这些结果表明，AMI患者的全血过滤性明显降低，这可被视为红细胞变形性的指标。溶栓治疗似乎对血液过滤性有积极作用，可能通过其除冠状动脉血栓溶解之外的治疗作用产生有益效果。
