Brunner R, Borberg H, Kadar J, Heidel M, Heidner K, Konen W
Department of Ophthalmology, University of Cologne, Germany.
Acta Med Austriaca. 1991;18 Suppl 1:63-5.
Reduction of hematocrit as well as elimination of fibrinogen and plasma proteins of higher molecular weight are effective approaches in hemorheology. A combination of these therapeutical concepts was applied in one patient with uveal effusion syndrome and in 16 patients with maculopathy. The hematocrit was reduced by erythrocyte apheresis. Fibrinogen and plasma proteins were eliminated by plasma exchange. In the case of uveal effusion syndrome the filling of the scleral veins as well as the uveal effusion were reduced. Furthermore visual function was improved significantly. In 9 of the 16 patients with maculopathy a significant increase in visual acuity occurred. The therapy described lowers significantly the following parameters: hematocrit, fibrinogen, serum proteins, plasma viscosity, erythrocyte aggregation and apparent whole blood viscosity (native and standardized). In a multiple linear regression analysis we found correlations as follows: plasma viscosity correlates with fibrinogen and proteins of higher molecular weight (r = 0.82), erythrocyte aggregation with fibrinogen and proteins of higher molecular weight (r = 0.88), standardized apparent whole blood viscosity with fibrinogen and proteins of higher molecular weight (r = 0.88) and native apparent whole blood viscosity with hematocrit, fibrinogen and proteins of higher molecular weight (r = 0.91).
降低血细胞比容以及清除纤维蛋白原和高分子量血浆蛋白是血液流变学中的有效方法。这些治疗理念的组合应用于1例葡萄膜渗漏综合征患者和16例黄斑病变患者。通过红细胞单采术降低血细胞比容，通过血浆置换清除纤维蛋白原和血浆蛋白。对于葡萄膜渗漏综合征患者，巩膜静脉充血及葡萄膜渗漏均减轻。此外，视觉功能显著改善。16例黄斑病变患者中有9例视力显著提高。所述治疗方法可显著降低以下参数：血细胞比容、纤维蛋白原、血清蛋白、血浆粘度、红细胞聚集以及表观全血粘度（自然状态和标准化状态）。在多元线性回归分析中，我们发现如下相关性：血浆粘度与纤维蛋白原和高分子量蛋白相关（r = 0.82），红细胞聚集与纤维蛋白原和高分子量蛋白相关（r = 0.88），标准化表观全血粘度与纤维蛋白原和高分子量蛋白相关（r = 0.88），自然状态表观全血粘度与血细胞比容、纤维蛋白原和高分子量蛋白相关（r = 0.91）。
