Awodu O A, Ajayi I O, Famodu A A
Department of Haematology and Blood Transfusion, School of Medicine, College of Medical Sciences, University of Benin, Benin City, Nigeria.
Clin Hemorheol Microcirc. 2007;36(4):267-75.
Haemorheological changes in response to therapy have not been fully determined in pulmonary tuberculosis patients living in developing countries. This study was aimed at monitoring haemorheological parameters in newly diagnosed pulmonary tuberculosis patients undergoing therapy. Haemorheological parameters were studied in 40 tuberculosis patients (17 males and 23 females, mean age 33.4+/-1.4 years, range 23-45 years) undergoing treatment and 10 newly diagnosed patients (5 males and 5 females mean age 33.0+/-2.1 years) along with 50 apparently healthy controls age and sex matched. There were significantly lower packed cell volume (PCV), platelet count (PC), and total white blood cell count (p<0.0001). Whole blood viscosity (WBV), plasma viscosity (PV), erythrocyte sedimentation rate (ESR), and plasma fibrinogen (PF) were significantly higher in pulmonary tuberculosis patients than controls (p<0.0001). The packed cell volume was significantly increased by the 8th week of therapy (p<0.01), there was a significant reduction in the erythrocyte sedimentation rate from the 4th week of therapy (p<0.0001). There was no significant change in blood viscosity by the 4th week of therapy (p>0.05), while the plasma fibrinogen showed significant reduction from the 4th week of therapy till 8th week of therapy (p<0.01 and p<0.0001 respectively). We conclude that thrombocytopaenia, stasis and hyperfibrinogenemia may predispose African PTB patients to bleeding and thrombotic disorders. Haemorheological parameters may be useful indices in assessing response to therapy and drug compliance in pulmonary tuberculosis patients living in developing countries.
生活在发展中国家的肺结核患者在治疗过程中的血液流变学变化尚未完全明确。本研究旨在监测新诊断的正在接受治疗的肺结核患者的血液流变学参数。对40例正在接受治疗的肺结核患者(17例男性和23例女性,平均年龄33.4±1.4岁,范围23 - 45岁)、10例新诊断患者(5例男性和5例女性,平均年龄33.0±2.1岁)以及50例年龄和性别匹配的健康对照者进行了血液流变学参数研究。其红细胞压积(PCV)、血小板计数(PC)和白细胞总数显著降低(p<0.0001)。肺结核患者的全血粘度(WBV)、血浆粘度(PV)、红细胞沉降率(ESR)和血浆纤维蛋白原(PF)显著高于对照组(p<0.0001)。治疗第8周时红细胞压积显著升高(p<0.01),治疗第4周起红细胞沉降率显著降低(p<0.0001)。治疗第4周时血液粘度无显著变化(p>0.05),而血浆纤维蛋白原从治疗第4周直至第8周显著降低(分别为p<0.01和p<0.0001)。我们得出结论,血小板减少、血流淤滞和高纤维蛋白原血症可能使非洲肺结核患者易患出血和血栓形成性疾病。血液流变学参数可能是评估发展中国家肺结核患者治疗反应和药物依从性的有用指标。