Shand B I
Lipid and Diabetes Research Group, Christchurch Hospital, New Zealand.
Clin Hemorheol Microcirc. 2002;27(1):13-6.
Polycystic kidney disease (PKD) is associated with an increased incidence of hypertension and cardiovascular abnormalities. As hemorheology is an important hemodynamic determinant and may contribute to vasculopathies we measured whole blood viscosity and red blood cell (RBC) and plasma rheological factors in 38 patients with PKD and compared this data with similar measurements in age- and sex-matched healthy controls. Renal function was assessed by plasma creatinine concentration. Analysis of the data showed that the PKD group had a significant reduction in mean hematocrit and an increase in mean plasma viscosity and mean plasma fibrinogen concentration. Intrinsic RBC rheology assessed by standardised viscosity measurements was impaired in patients with PKD compared to control subjects. The changes in plasma and RBC rheology did not however result in increased whole blood viscosity in the patients with PKD due to the reduction in hematocrit level. Correlation analyses demonstrated a significant relationship between increased plasma creatinine concentration and lower hematocrit, decreased whole blood viscosity and impaired RBC deformability but not with increased plasma viscosity or plasma fibrinogen concentration. This study shows that although PKD is associated with mild abnormalities in plasma rheology and intrinsic RBC rheology these changes are offset by a reduction in hematocrit. The changes in RBC rheological determinants in PKD appeared to be related to the degree of renal impairment.
多囊肾病(PKD)与高血压和心血管异常的发病率增加有关。由于血液流变学是一个重要的血流动力学决定因素,可能导致血管病变,我们测量了38例PKD患者的全血粘度、红细胞(RBC)和血浆流变学因子,并将这些数据与年龄和性别匹配的健康对照者的类似测量结果进行比较。通过血浆肌酐浓度评估肾功能。数据分析表明,PKD组的平均血细胞比容显著降低,平均血浆粘度和平均血浆纤维蛋白原浓度升高。与对照受试者相比,PKD患者通过标准化粘度测量评估的内在红细胞流变学受损。然而,由于血细胞比容水平降低,PKD患者的血浆和红细胞流变学变化并未导致全血粘度增加。相关性分析表明,血浆肌酐浓度升高与较低的血细胞比容、降低的全血粘度和受损的红细胞变形能力之间存在显著关系,但与血浆粘度或血浆纤维蛋白原浓度升高无关。这项研究表明,虽然PKD与血浆流变学和内在红细胞流变学的轻度异常有关,但这些变化被血细胞比容的降低所抵消。PKD中红细胞流变学决定因素的变化似乎与肾功能损害程度有关。