Vayá Amparo, Murado Julián, Santaolaria Marisa, Simó María, Micó Luisa, Calvo Javier, Todolí José, Ricart Jose M
Haemorheology and Thrombosis Unit, Department of Clinical Pathology, La Fe University Hospital, Valencia, Spain.
Clin Hemorheol Microcirc. 2008;38(1):23-9.
Atherothrombotic events are significant factors of mortality and morbidity in patients with systemic lupus erythematosus (SLE). The extent that rheological factors may be involved in these events in these patients has not been established. We measured the following rheological parameters in 86 patients with SLE, of whom 16 had suffered venous and/or arterial thrombotic events, and in 86 healthy controls: fibrinogen (Fbg), plasma viscosity (PV), blood viscosity at 230 s(-1) both at native haematocrit (BVn 230 s(-1) and corrected to 45% (BVc 230 s(-1), erythrocyte aggregation at stasis (AE0) and at 3 s(-1) (AE1), aggregation time (Ta), aggregation index at 10 s (AI10), disaggregation threshold (gammaD), and erythrocyte deformability (ED). In addition glucose, total cholesterol (T-Chol), triglycerides (TG), haematocrit (Hct) and Body Mass Index (BMI) were determined. SLE Disease Activity Index (SLEDAI) was also assessed. The patients showed a significant increase in BMI (P=0.030), TG (P<0.001), PV (P=0.007), AE0 (P=0.005), AE1 (P=0.006), AI10 (P=0.024), gammaD (P=0.001), Fbg (P=0.050); and a significant decrease in Ta (P<0.001), Hct (P<0.001) and BVn 230 s(-1) (P=0.003). When patients with SLEDAI
动脉粥样硬化血栓形成事件是系统性红斑狼疮(SLE)患者死亡率和发病率的重要因素。流变学因素在这些患者的此类事件中所起的作用程度尚未明确。我们对86例SLE患者(其中16例曾发生静脉和/或动脉血栓形成事件)以及86例健康对照者进行了以下流变学参数的测量:纤维蛋白原(Fbg)、血浆粘度(PV)、在自然血细胞比容下230 s⁻¹时的血液粘度(BVn 230 s⁻¹)以及校正至45%时的血液粘度(BVc 230 s⁻¹)、静态时的红细胞聚集(AE0)和3 s⁻¹时的红细胞聚集(AE1)、聚集时间(Ta)、10 s时的聚集指数(AI10)、解聚阈值(γD)以及红细胞变形性(ED)。此外,还测定了血糖、总胆固醇(T-Chol)、甘油三酯(TG)、血细胞比容(Hct)和体重指数(BMI)。同时评估了SLE疾病活动指数(SLEDAI)。患者的BMI(P = 0.030)、TG(P < 0.001)、PV(P = 0.007)、AE0(P = 0.005)、AE1(P = 0.006)、AI10(P = 0.024)、γD(P = 0.001)、Fbg(P = 0.050)显著升高;Ta(P < 0.001)、Hct(P < 0.001)和BVn 230 s⁻¹(P = 0.003)显著降低。比较SLEDAI<或>10的患者时,后者的Hct(P = 0.041)和BVn 230 s⁻¹(P = 0.017)低于SLEDAI较低的患者。在比较发生过血栓形成事件的患者与未发生过血栓形成事件的患者时,所分析的任何参数均未发现显著差异。我们的结果表明,尽管SLE患者存在中度的流变学改变,但这些改变似乎并非导致这些患者血栓形成倾向增加的原因。