Wiek J, Krause M, Wiederholt M, Hansen L L
Universitäts-Augenklinik, Freiburg, Bundesrepublik Deutschland.
Fortschr Ophthalmol. 1990;87(6):671-4.
Basic hemorheological parameters like packed cell volume (PCV), plasma viscosity, red cell aggregation, red cell filterability and whole blood viscosity were measured in 18 patients (14 women, aged 75.4 years) with giant cell arteritis before and after treatment with steroids. The patient group was compared to controls (n = 27, age: 69.8 years) with matched age and cardiovascular risc factors. While no changes in red cell aggregation and filterability could be observed plasma viscosity was increased (1.59 +/- 0.14 mm2/s) by about 20%. The typical anemia of patients with giant cell arteritis (PVC: 0.38 +/- 0.05) prevented an increase in whole blood viscosity at high and medium shear rates (6.6 +/- 0.14 cP = mPas at 23/s). After a fortnight of systemic treatment with high doses of steroids the PCV had normalized and plasma viscosity was even lower than in controls. Thus the blood fluidity was improved as shown by a fall in whole blood viscosity (5.5 +/- 0.7 cP = mPas at 23/s). Results showed: (1) increased plasma viscosity probably induced by increased fibrinogen concentration and (2) an improvement in blood fluidity by treatment with steroids. As the plasma viscosity may participate in the deterioration of microcirculation in patients with giant cell arteritis, lowering the fibrinogen may possibly prevent a further decrease in visual acuity during the first few days of steroid treatment.
在18例巨细胞动脉炎患者(14名女性,年龄75.4岁)接受类固醇治疗前后,测量了血细胞比容(PCV)、血浆粘度、红细胞聚集性、红细胞滤过率和全血粘度等基本血液流变学参数。将患者组与年龄和心血管风险因素相匹配的对照组(n = 27,年龄:69.8岁)进行比较。虽然未观察到红细胞聚集性和滤过率的变化,但血浆粘度增加了约20%(1.59 +/- 0.14 mm2/s)。巨细胞动脉炎患者典型的贫血(PVC:0.38 +/- 0.05)阻止了高、中剪切率下全血粘度的增加(23/s时为6.6 +/- 0.14 cP = mPas)。在高剂量类固醇全身治疗两周后,PCV恢复正常,血浆粘度甚至低于对照组。因此,全血粘度下降(23/s时为5.5 +/- 0.7 cP = mPas)表明血液流动性得到改善。结果显示:(1)血浆粘度增加可能是由纤维蛋白原浓度升高引起的;(2)类固醇治疗可改善血液流动性。由于血浆粘度可能参与巨细胞动脉炎患者微循环的恶化,降低纤维蛋白原可能有助于在类固醇治疗的最初几天预防视力进一步下降。