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肾移植受者的血液粘度因素与闭塞性动脉疾病

Blood viscosity factors and occlusive arterial disease in renal transplant recipients.

作者信息

Dintenfass L, Ibels L S

出版信息

Nephron. 1975;15(6):456-65. doi: 10.1159/000180529.

Abstract

29 cadaveric renal transplant recipients were assessed clinically for evidence of occlusive arterial disease prior to undergoing blood viscosity studies. Nineteen patients had manifest arterial disease (myocardial infarction, cerebral thrombosis, angina, intermittent claudication, absent peripheral pulses), while ten were free from vascular complications. Patients with arterial disease showed significant elevations of plasma viscosity (p less than 0.005), aggregation of red cells measured both at 37 and 20 degrees C (p less than 0.05), fibrinogen (p less than 0.005), serum triglyceride (p less than 0.01), serum cholesterol (p less than 0.01), erythrocyte sedimentation rate (p less than 0.02), and a significant reduction in the albumin/fibrinogen ratio (p less than 0.005) when compared with those free of disease. Two patients with no apparent vascular disease when investigated were found to have distinctly abnormal blood viscosity factors, and one subsequently developed retinal arterial thrombosis while the other suffered serious damage of the graft within 3 months of viscosity study. When all patients were considered together, significant correlations were found between viscosity of artificial thrombi or aggregation of red cells and fibrinogen level (both p less than 0.05), and serum triglyceride level (both p less than 0.05); and between rigidity of red cells and the parathyroid hormone level (p less than 0.01).

摘要

在进行血液粘度研究之前,对29名尸体肾移植受者进行了临床评估,以寻找闭塞性动脉疾病的证据。19名患者有明显的动脉疾病(心肌梗死、脑血栓形成、心绞痛、间歇性跛行、外周脉搏消失),而10名患者没有血管并发症。与无疾病的患者相比,患有动脉疾病的患者血浆粘度显著升高(p<0.005),在37℃和20℃下测量的红细胞聚集(p<0.05)、纤维蛋白原(p<0.005)、血清甘油三酯(p<0.01)、血清胆固醇(p<0.01)、红细胞沉降率(p<0.02),白蛋白/纤维蛋白原比值显著降低(p<0.005)。在研究时无明显血管疾病的两名患者被发现血液粘度因子明显异常,其中一名随后发生视网膜动脉血栓形成,另一名在粘度研究3个月内移植肾遭受严重损害。当将所有患者综合考虑时,发现人工血栓粘度或红细胞聚集与纤维蛋白原水平(均p<0.05)以及血清甘油三酯水平(均p<0.05)之间存在显著相关性;红细胞刚性与甲状旁腺激素水平之间存在显著相关性(p<0.01)。

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