Bertram B, Wolf S, Kaufhold F, Jung F, Kiesewetter H, Reim M
Augenklinik Medizinischen Einrichtungen der RWTH, Aachen, Bundesrepublik Deutschland.
Fortschr Ophthalmol. 1991;88(4):321-5.
The rheological parameters hematocrit, plasma viscosity, red blood cell aggregation and blood cell rigidity were measured in 256 adult-onset (type II) diabetics. The stage of diabetic retinopathy was graded by means of ophthalmoscopy and videofluorescein angiography. The mean values of hematocrit (men 45 +/- 5%, women 42 +/- 5%) and red blood cell rigidity (1.01 +/- 0.08) were equal to those in normal subjects. Plasma viscosity (1.40 +/- 0.10) mPas, normals: 1.24 +/- 0.05 mPas) and red blood cell aggregation (16.0 +/- 4.2, normals: 14.6 +/- 3.2) were increased over the values in normals. The groups with different stages of diabetic retinopathy showed no difference in all rheological parameters. Plasma viscosity and red blood cell aggregation were determined partly by the levels of the large plasma proteins. In the type II diabetics fibrinogen was the most markedly elevated large plasma protein (4.1 +/- 1.2 g/l, normals: 3.2 +/- 0.6 g/l). Significant correlations were found between plasma viscosity and fibrinogen (0.49); plasma viscosity and alpha-2-macroglobulin (0.33); red blood cell aggregation and alpha-2-macroglobulin (0.28); and red blood cell aggregation and immunoglobulin M (0.25). The elevation of red blood cell aggregation and plasma viscosity may be one of the reasons for disturbed microcirculation and fundus changes in diabetic retinopathy.
对256例成年发病（II型）糖尿病患者测量了血细胞比容、血浆粘度、红细胞聚集性和血细胞刚性等流变学参数。通过检眼镜检查和荧光素血管造影对糖尿病视网膜病变的阶段进行分级。血细胞比容的平均值（男性45±5%，女性42±5%）和红细胞刚性（1.01±0.08）与正常受试者的平均值相等。血浆粘度（1.40±0.10）mPas，正常人为：1.24±0.05 mPas）和红细胞聚集性（16.0±4.2，正常人为：14.6±3.2）高于正常水平。不同阶段糖尿病视网膜病变的组在所有流变学参数上均无差异。血浆粘度和红细胞聚集性部分由血浆大分子蛋白水平决定。在II型糖尿病患者中，纤维蛋白原是升高最明显的血浆大分子蛋白（4.1±1.2 g/l，正常人为：3.2±0.6 g/l）。发现血浆粘度与纤维蛋白原之间存在显著相关性（0.49）；血浆粘度与α-2-巨球蛋白之间存在显著相关性（0.33）；红细胞聚集性与α-2-巨球蛋白之间存在显著相关性（0.28）；红细胞聚集性与免疫球蛋白M之间存在显著相关性（0.25）。红细胞聚集性和血浆粘度的升高可能是糖尿病视网膜病变中微循环障碍和眼底改变的原因之一。
