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缺血性脑梗死急性期患者的渗透稳态与血液流变学

[Osmotic homeostasis and blood rheology in patients in the acute period of ischemic cerebral infarction].

作者信息

Gusev E I, Chukanova E I, Iasamanova A N

出版信息

Zh Nevropatol Psikhiatr Im S S Korsakova. 1990;90(7):12-6.

PMID:2175076
Abstract

The authors describe the role of changes in osmotic homeostasis and hemorheology in the pathogenesis of ischemic brain stroke. 48 patients experiencing an acute period of ischemic brain stroke were examined. For this purpose the following methods were employed: measurements of blood, urine and CSF osmolality by Knauer osmometer; glucose and urea by the enzymatic assay; blood electrolytes by flame photometer; aggregation of platelets, red blood cells, blood viscosity, fibrinogen, hematocrit; the ethanol test, and thromboelastography. The data obtained demonstrate that the unfavorable prognostic signs may include steady and increasing hyperosmia, rise of the mmol discriminant of osmolality to over 35-40 mOsm/l, a progressive decrease of the rheological blood parameters and of colloid-osmotic pressure together with a progressive reduction of the urine/blood osmolality, which points to the rupture of the compensation for osmotic homeostasis and decompensation for the functional system regulating the blood aggregation state.

摘要

作者描述了渗透稳态和血液流变学变化在缺血性脑卒发病机制中的作用。对48例处于缺血性脑卒急性期的患者进行了检查。为此采用了以下方法:用克瑙尔渗透压计测量血液、尿液和脑脊液渗透压;用酶法测定葡萄糖和尿素;用火焰光度计测定血液电解质;检测血小板聚集、红细胞聚集、血液粘度、纤维蛋白原、血细胞比容;乙醇试验和血栓弹性描记法。所获得的数据表明,不良预后体征可能包括持续且不断升高的高渗状态、渗透压的毫摩尔判别值升至超过35 - 40 mOsm/l、血液流变学参数和胶体渗透压逐渐降低,以及尿/血渗透压逐渐降低,这表明渗透稳态的代偿机制破裂,调节血液聚集状态的功能系统失代偿。

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