Department of Medicine, Uppsala University Hospital, Uppsala, Sweden.
Clin Hemorheol Microcirc. 2012;50(4):301-11. doi: 10.3233/CH-2011-1505.
It has previously been shown that a high hemoglobin value, a major determinant of whole blood viscosity (WBV), predicts cardiovascular events. One putative mechanism might be an impaired endothelial function. Erythrocyte deformability is another rheologic feature of the erythrocyte being of importance for the flow properties of the blood, especially in the capillaries. The present study evaluates the relationships between blood viscosity, erythrocyte deformability assessed as erythrocyte fluidity (EF), coronary risk and endothelial vasodilatory function. In the population-based PIVUS study (1016 subjects aged 70); endothelium-dependent vasodilation (EDV) was evaluated by the invasive forearm technique with acetylcholine given in the brachial artery and the brachial artery ultrasound technique with measurement of flow-mediated dilatation (FMD). WBV, plasma viscosity (PV) and EF were measured in a random sample of 573 subjects. WBV and PV were positively and EF negatively related to Framingham risk score. EDV was inversely related to both whole blood and plasma viscosity. FMD was not related to any rheologic variable. In multiple regression analyses WBV and EF were significantly related to EDV independently of gender, hypertension, smoking, hypercholesterolemia, obesity and diabetes. Acetylcholine-induced vasodilation in the forearm, but not FMD, was negatively related to whole blood viscosity and positively related to EF independently of traditional risk factors in elderly subjects, indicating a pathophysiological link between impaired hemorheology and coronary risk.
先前的研究表明，全血黏度（WBV）的主要决定因素——血红蛋白值偏高可预测心血管事件的发生。一种可能的机制是内皮功能受损。红细胞变形性是红细胞另一个流变学特征，对血液的流动特性（尤其是在毛细血管中）很重要。本研究评估了血液黏度、作为红细胞流动性（EF）评估的红细胞变形性、冠状动脉风险和内皮血管舒张功能之间的关系。在基于人群的 PIVUS 研究（1016 名年龄 70 岁的受试者）中，通过乙酰胆碱在前臂动脉中的介入性前臂技术和肱动脉超声技术来评估内皮依赖性血管舒张（EDV），并测量血流介导的扩张（FMD）。在 573 名随机样本中测量了 WBV、血浆黏度（PV）和 EF。WBV 和 PV 与 Framingham 风险评分呈正相关，EF 与 Framingham 风险评分呈负相关。EDV 与全血黏度和血浆黏度均呈负相关。FMD 与任何流变学变量均无关。在多元回归分析中，WBV 和 EF 与 EDV 独立相关，与性别、高血压、吸烟、高胆固醇血症、肥胖和糖尿病无关。乙酰胆碱诱导的前臂血管舒张，而不是 FMD，与全血黏度呈负相关，与 EF 呈正相关，这与老年受试者的传统危险因素无关，表明血液流变学受损与冠状动脉风险之间存在病理生理学联系。
