Lao Jian-Xin, Gu Miao-Ning, Xiao Jin-Fang, Lu Xiao-Ming
Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Di Yi Jun Yi Da Xue Xue Bao. 2005 Apr;25(4):438-40.
To investigate the effects of hemodilution with hydroxyethyl-starch (HES) on hemorheology in patients with chronic liver diseases in vitro.
Twenty-one healthy volunteers were selected as the control group and 21 patients with chronic liver disease as the study group. Both of the two groups were divided into HSE (n=11) and Ringer's solution (n=10) groups. Venous blood of 12 ml were collected from each subject and aliquoted into 4 samples, one of the 4 samples served as control (sample 1), and the other 3 (samples 2, 3, 4 respectively) were diluted with 6%; HES or Ringer's solution to cause the hematocrit (Hct) decrease to 30%;, 25%; or 20%;. The rheological parameters including Hct, blood viscosity, plasma viscosity, index of red blood cell aggregation (ARBC) and index of red blood cell rigidity (RRBC) were examined.
The Hct of the study group was significantly lower than that of the control group (P<0.05), but plasma viscosity and ARBC were significantly higher. After being diluted by HES, the blood viscosity and ARBC decreased significantly in the study group (P<0.05), and were not significantly different from those of the control group (P>0.05) when Hct=25%; and 20%;. The RRBC of the study group was increased, but the increment was significantly higher than that of control group (P>0.05) only when Hct=20%;.
The ARBC of patients with chronic liver diseases was significantly higher. Hemodilution with 6%; HES could significantly reduce the blood viscosity and ARBC.
体外研究羟乙基淀粉（HES）血液稀释对慢性肝病患者血液流变学的影响。
选取21名健康志愿者作为对照组，21例慢性肝病患者作为研究组。两组均分为羟乙基淀粉组（n = 11）和林格液组（n = 10）。采集每位受试者12 ml静脉血，分成4份样本，其中1份样本作为对照（样本1），另外3份（分别为样本2、3、4）用6%的羟乙基淀粉或林格液稀释，使血细胞比容（Hct）降至30%、25%或20%。检测血液流变学参数，包括血细胞比容、全血黏度、血浆黏度、红细胞聚集指数（ARBC）和红细胞刚性指数（RRBC）。
研究组的血细胞比容显著低于对照组（P<0.05），但血浆黏度和红细胞聚集指数显著更高。研究组经羟乙基淀粉稀释后，全血黏度和红细胞聚集指数显著降低（P<0.05），当血细胞比容为25%和20%时，与对照组无显著差异（P>0.05）。研究组的红细胞刚性指数升高，但仅当血细胞比容为20%时，升高幅度显著高于对照组（P>0.05）。
慢性肝病患者的红细胞聚集指数显著更高。6%的羟乙基淀粉血液稀释可显著降低全血黏度和红细胞聚集指数。
