de Simone G, Devereux R B, Chien S, Alderman M H, Atlas S A, Laragh J H
Department of Medicine, New York Hospital-Cornell Medical Center, New York 10021.
Circulation. 1990 Jan;81(1):107-17. doi: 10.1161/01.cir.81.1.107.
Although increased blood viscosity occurs in several cardiovascular diseases, little is known of factors influencing blood rheology in normal adults. Accordingly, we examined the relations of whole blood viscosity (WBV) to its rheologic determinants (hematocrit level, plasma viscosity, protein concentration, and red cell aggregability and rigidity), to demographic and laboratory variables, and to cardiovascular risk factors in 128 normotensive employed adults. Hematocrit levels accounted for 67-84% of variability of WBV at shear rates from 208 to 0.1 sec-1 with lesser contributions from plasma viscosity, red cell aggregability, and rigidity (multiple r = 0.95-0.97); WBV was predicted accurately from standard measurements of hematocrit and total plasma protein levels (multiple r = 0.78-0.92 in "learning" and "test" analysis). Male sex, obesity, dietary Na+ intake, and increasing age had additive effects on WBV (multiple r greater than or equal to 0.59, p less than 0.00001); the last three of these factors and black race independently predicted plasma viscosity (multiple r = 0.36, p less than 0.001). Among regulators of plasma volume, plasma renin activity and urinary Na+ excretion bore independent positive relations to WBV. Diastolic and mean blood pressures were independent predictors of WBV and hematocrit levels (all p less than 0.05). Conventional risk factors (e.g., triglycerides, obesity, and cholesterol levels) were positively related to WBV or plasma viscosity. Thus, in apparently normal adults, 1) WBV or plasma viscosity are increased by male sex, obesity, high sodium intake, aging, and black race, 2) WBV is positively related to plasma renin activity, 3) WBV or plasma viscosity are related to diastolic and mean blood pressures, triglycerides and cholesterol concentrations, and 4) WBV can be predicted from simple measurements of hematocrit and total plasma protein levels.
尽管在多种心血管疾病中会出现血液粘度增加的情况，但对于影响正常成年人血液流变学的因素却知之甚少。因此，我们在128名血压正常的在职成年人中，研究了全血粘度（WBV）与其流变学决定因素（血细胞比容水平、血浆粘度、蛋白质浓度以及红细胞聚集性和刚性）、人口统计学和实验室变量以及心血管危险因素之间的关系。在剪切速率从208至0.1秒-1的情况下，血细胞比容水平占WBV变异性的67 - 84%，血浆粘度、红细胞聚集性和刚性的贡献较小（复相关系数r = 0.95 - 0.97）；根据血细胞比容和总血浆蛋白水平的标准测量能够准确预测WBV（在“学习”和“测试”分析中复相关系数r = 0.78 - 0.92）。男性、肥胖、饮食中钠的摄入量以及年龄增长对WBV有累加效应（复相关系数r大于或等于0.59，p < 0.00001）；这些因素中的后三个因素以及黑人种族可独立预测血浆粘度（复相关系数r = 0.36，p < 0.001）。在血浆容量调节因子中，血浆肾素活性和尿钠排泄与WBV呈独立正相关。舒张压和平均血压是WBV和血细胞比容水平的独立预测因子（所有p < 0.05）。传统危险因素（如甘油三酯、肥胖和胆固醇水平）与WBV或血浆粘度呈正相关。因此，在表面上正常的成年人中，1）男性、肥胖、高钠摄入、衰老和黑人种族会使WBV或血浆粘度升高，2）WBV与血浆肾素活性呈正相关，3）WBV或血浆粘度与舒张压、平均血压、甘油三酯和胆固醇浓度有关，4）通过简单测量血细胞比容和总血浆蛋白水平即可预测WBV。
