Shabanov V A, Terekhina E V, Kostrov V A
Ter Arkh. 2001;73(10):70-3.
To study hemorheology in patients with essential hypertension (EH), to improve EH treatment in terms of blood rheology.
Blood rheology, microcirculation, lipid plasm spectrum, central hemodynamics were studied in 90 patients with mild and 83 patients with moderate or severe EH as well as 30 healthy controls before and after treatment (hypotensive drugs, essential phospholipids, intravenous laser blood radiation, plasmapheresis).
Hemorrheological disorders (subnormal deformability of the red cells and elastoviscosity of their membranes, disk-spherical transformation and hyperaggregation of blood cells, high dynamic viscosity) correlated with the disease severity, arterial pressure and total peripheral vascular resistance. Long-term (1-1.5 years) hypotensive therapy, especially with combination of beta-blockers with diuretics, has a negative effect on blood rheology. Optimisation of EH treatment in terms of blood rheology consists in using essential phospholipids in stable hypertension, intravenous laser radiation in complicated hypertension, plasmapheresis in drug-resistant hypertension. Such an approach not only significantly improves hemorheology but also provides good clinical and hypotensive effects in 75-80% patients.
Blood viscodynamics should be taken into consideration in individual treatment of hypertensive patients.
研究原发性高血压（EH）患者的血液流变学，以便从血液流变学角度改善EH的治疗。
对90例轻度EH患者、83例中度或重度EH患者以及30名健康对照者在治疗（使用降压药物、必需磷脂、静脉激光血液照射、血浆置换）前后进行血液流变学、微循环、血脂谱、中心血流动力学研究。
血液流变学紊乱（红细胞变形能力及细胞膜弹性黏滞度低于正常、血细胞盘 - 球转化及高聚集性、动态黏度高）与疾病严重程度、动脉压及总外周血管阻力相关。长期（1 - 1.5年）降压治疗，尤其是β受体阻滞剂与利尿剂联合使用，对血液流变学有负面影响。从血液流变学角度优化EH治疗包括在稳定型高血压中使用必需磷脂、在复杂型高血压中进行静脉激光照射、在难治性高血压中进行血浆置换。这种方法不仅能显著改善血液流变学，还能在75 - 80%的患者中产生良好的临床和降压效果。
在高血压患者的个体化治疗中应考虑血液黏滞动力学。
