Cortinovis A, Crippa A, Crippa M, Bosoni T, Moratti R
Dipartimento di Medicina Interna e Terapia Medica, Università degli Studi di Pavia.
Minerva Cardioangiol. 1992 Sep;40(9):317-22.
In NIDDM diabetic subjects, the microcirculatory damage shows a double aspect: an alteration of the vascular wall, particularly of the arteriolar capillary, and a hemorheological alteration at the level of the capillary district. In the microcirculation, because of the low velocity of the flow and the inverse relationship between capillary size and RBC diameter, the viscosity has an important role with its components: RBC viscosity and deformability. Even the erythrocyte aggregation has a key role as resultant of the attracting and repulsing forces, among which the plasma-RBC viscosity and the deformability play opposite role. Our method allows to evaluate the erythrocyte, the whole blood, the plasma and the plasma-RBC viscosity, and the deformability. Studies from this laboratory in NIDDM subjects show an increase in the blood viscosity, a decrease in the erythrocyte deformability and plasma-RBC viscosity. It is suggested that in microcirculatory district the flow reductions are particularly of hemorheological type and that the sludged blood is an "optical" phenomenon with poor meaning. We consider some hematological parameters, namely the Hgb A1c %, Hgb concentration, RBC count, MCV, etcetera.
在非胰岛素依赖型糖尿病(NIDDM)患者中,微循环损伤呈现出两个方面:血管壁的改变,尤其是小动脉毛细血管的改变,以及毛细血管区域水平的血液流变学改变。在微循环中,由于血流速度低以及毛细血管大小与红细胞直径之间的反比关系,粘度及其组成部分(红细胞粘度和变形性)起着重要作用。甚至红细胞聚集作为吸引和排斥力的结果也起着关键作用,其中血浆 - 红细胞粘度和变形性起着相反的作用。我们的方法可以评估红细胞、全血、血浆和血浆 - 红细胞粘度以及变形性。本实验室对NIDDM患者的研究表明,血液粘度增加,红细胞变形性和血浆 - 红细胞粘度降低。有人提出,在微循环区域,血流减少尤其属于血液流变学类型,而血液淤滞是一种意义不大的“光学”现象。我们考虑一些血液学参数,即糖化血红蛋白A1c%、血红蛋白浓度、红细胞计数、平均红细胞体积等。