Reinhart W H, Kayser B, Singh A, Waber U, Oelz O, Bärtsch P
Department of Internal Medicine, University of Bern, Switzerland.
J Appl Physiol (1985). 1991 Sep;71(3):934-8. doi: 10.1152/jappl.1991.71.3.934.
The role of blood rheology in the pathogenesis of acute mountain sickness and high-altitude pulmonary edema was investigated. Twenty-three volunteers, 12 with a history of high-altitude pulmonary edema, were studied at low altitude (490 m) and at 2 h and 18 h after arrival at 4,559 m. Eight subjects remained healthy, seven developed acute mountain sickness, and eight developed high-altitude pulmonary edema. Hematocrit, whole blood viscosity, plasma viscosity, erythrocyte aggregation, and erythrocyte deformability (filtration) were measured. Plasma viscosity and erythrocyte deformability remained unaffected. The hematocrit level was lower 2 h after the arrival at high altitude and higher after 18 h compared with low altitude. The whole blood viscosity changed accordingly. The erythrocyte aggregation was about doubled 18 h after the arrival compared with low-altitude values, which reflects the acute phase reaction. There were, however, no significant differences in any rheological parameters between healthy individuals and subjects with acute mountain sickness or high-altitude pulmonary edema, either before or during the illness. We conclude that rheological abnormalities can be excluded as an initiating event in the development of acute mountain sickness and high-altitude pulmonary edema.
研究了血液流变学在急性高原病和高原肺水肿发病机制中的作用。对23名志愿者进行了研究，其中12名有高原肺水肿病史，在低海拔（490米）以及到达4559米海拔处2小时和18小时后进行观察。8名受试者保持健康，7名发生急性高原病，8名发生高原肺水肿。测量了血细胞比容、全血粘度、血浆粘度、红细胞聚集性和红细胞变形性（滤过率）。血浆粘度和红细胞变形性未受影响。与低海拔相比，到达高海拔2小时后血细胞比容水平较低，18小时后较高。全血粘度也相应改变。到达高海拔18小时后的红细胞聚集性比低海拔时约增加一倍，这反映了急性期反应。然而，在健康个体与急性高原病或高原肺水肿患者之间，无论在疾病发生前还是发病期间，任何血液流变学参数均无显著差异。我们得出结论，血液流变学异常可被排除为急性高原病和高原肺水肿发生的起始因素。
