Katayama Yasutomi, Horigome Hitoshi, Murakami Takashi, Takahashi-Igari Miho, Miyata Daiki, Tanaka Kiyoji
Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8577, Japan.
Clin Hemorheol Microcirc. 2006;35(4):499-508.
Blood hyperviscosity due to secondary erythrocytosis is a common pathologic feature of cyanotic congenital heart disease (CCHD). In CCHD, it is possible that hematological parameters other than red blood cells influence blood rheology. We measured blood passage time to evaluate the blood rheology in patients with CCHD (n=18, age: 15.3+/-11.9 years, mean +/- SD) and age-matched control subjects (n=27) using the microchannel array flow analyzer (MC-FAN), and the results [several hematological parameters, including hematocrit (Hct)] were compared. Blood passage time in the CCHD group was prolonged, compared with the control group (67.6+/-27.2 s vs. 44.6+/-6.7 s). For the CCHD group, blood passage time correlated significantly with red blood cell (RBC) count, hemoglobin (Hb) concentration, Hct, mean corpuscular hemoglobin concentration (MCHC), platelet (Plt) count, high-density lipoprotein cholesterol (HDL-C) level, and triglycerides (TG) level (RBC, r=0.77; Hb, r=0.69; Hct, r=0.73; MCHC, r=-0.64; Plt, r=-0.49; TG, r=0.53; HDL-C, r=-0.49, p<0.05 for each variable). For all 45 subjects, blood passage time correlated significantly with HbA1c level (r=0.45, p<0.01) and tissue-type plasminogen activator (t-PA) antigen level (r=0.46, p<0.01). Our results indicated that blood rheology is reduced in patients with CCHD as expressed by prolonged blood passage time, and it may be defined by several blood parameters in addition to erythrocytosis.
继发性红细胞增多症所致的血液高黏滞性是青紫型先天性心脏病(CCHD)的常见病理特征。在CCHD中,除红细胞外的血液学参数有可能影响血液流变学。我们使用微通道阵列流动分析仪(MC-FAN)测量了CCHD患者(n = 18,年龄:15.3±11.9岁,均值±标准差)和年龄匹配的对照受试者(n = 27)的血液通过时间以评估血液流变学,并比较了结果[包括血细胞比容(Hct)在内的多个血液学参数]。与对照组相比,CCHD组的血液通过时间延长(67.6±27.2秒对44.6±6.7秒)。对于CCHD组,血液通过时间与红细胞(RBC)计数、血红蛋白(Hb)浓度、Hct、平均红细胞血红蛋白浓度(MCHC)、血小板(Plt)计数、高密度脂蛋白胆固醇(HDL-C)水平和甘油三酯(TG)水平显著相关(RBC,r = 0.77;Hb,r = 0.69;Hct,r = 0.73;MCHC,r = -0.64;Plt,r = -0.49;TG,r = 0.53;HDL-C,r = -0.49,每个变量p<0.05)。对于所有45名受试者,血液通过时间与糖化血红蛋白A1c(HbA1c)水平(r = 0.45,p<0.01)和组织型纤溶酶原激活剂(t-PA)抗原水平(r = 0.46,p<0.01)显著相关。我们的结果表明,CCHD患者的血液流变学降低,表现为血液通过时间延长,并且除红细胞增多症外,它可能由多个血液参数所决定。