Kenyeres P, Juricskay I, Tarsoly P, Kesmarky G, Mühl D, Toth K, Bogar L
1st Department of Medicine, University of Pécs, Hungary.
Clin Hemorheol Microcirc. 2008;38(1):51-6.
Increased blood viscosity has not been associated with mortality risk in coronary heart disease (CHD). We aimed to investigate the predictive power of hematocrit per blood viscosity (Hct/BV) ratio as a marker of rheological oxygen carrying capacity of the blood to assess mortality risk of CHD. Elective coronary angiography was performed and CHD was proved in 109 patients in 1996 and 1997. In 78 cases (72%) complete follow up information was obtained in February 2006. During the follow up time (mean 8.9 years) 10 patients died due to cardiac cause (group C). Two patients died due to non-cardiac cause and 66 were still alive at the end of the follow up period (group NC, n=68). Mean hematocrit per blood viscosity (Hct/BV) ratio was significantly lower in group C comparing to NC (87+/-5; 93+/-9 Pa(-1)s(-1), SD, respectively, p=0.022). Other factors (body mass index, serum cholesterol, fibrinogen, hematocrit, plasma and blood viscosity, cardiac index, left ventricular ejection fraction) provided no statistical differences. Kaplan-Meier survival analysis showed only the impact of fibrinogen and Hct/BV ratio on cardiac mortality (p=0.029 and 0.009, respectively). Receiver operating characteristic curves proved only Hct/BV ratio to be able to differentiate between groups (area under curve: 0.716, p=0.028). Hct/BV ratio showed significant negative correlation with the frequency of hospital admissions (r=-0.377, p=0.03). Low Hct/BV ratio can be regarded as a risk factor of cardiac death in CHD.
血液粘度增加与冠心病(CHD)的死亡风险无关。我们旨在研究血细胞比容与血液粘度之比(Hct/BV)作为血液流变学携氧能力标志物的预测能力,以评估冠心病的死亡风险。1996年和1997年对109例患者进行了选择性冠状动脉造影,并证实患有冠心病。2006年2月,在78例(72%)患者中获得了完整的随访信息。在随访期间(平均8.9年),1名患者因心脏原因死亡(C组)。2名患者因非心脏原因死亡,66名患者在随访期末仍存活(非C组,n = 68)。与非C组相比,C组的平均血细胞比容与血液粘度之比(Hct/BV)显著降低(分别为87±5;93±9 Pa⁻¹s⁻¹,标准差,p = 0.022)。其他因素(体重指数、血清胆固醇、纤维蛋白原、血细胞比容、血浆和血液粘度、心脏指数、左心室射血分数)无统计学差异。Kaplan-Meier生存分析显示,只有纤维蛋白原和Hct/BV比值对心脏死亡率有影响(分别为p = 0.029和0.009)。受试者工作特征曲线证明,只有Hct/BV比值能够区分不同组(曲线下面积:0.716,p = 0.028)。Hct/BV比值与住院频率呈显著负相关(r = -0.377,p = 0.03)。低Hct/BV比值可被视为冠心病心脏死亡的危险因素。