Kozlov V A, Aleksandrova N P, Gladshteĭn M D, Gushchin B L
Urol Nefrol (Mosk). 1990 Jan-Feb(1):3-7.
A total of 18 patients with pyoseptic urological diseases (the main group) treated with plasmapheresis and 18 patients who were not (the control group) were studied for certain rheological parameters: platelet and red cell aggregation, number of platelets, hematocrit, ESR, viscosity values of the blood with a shift rate of 9 and 105 s-1 and osmotic resistance of red cells. 18 patients were exposed to 26 plasmapheresis sessions with a plasma removal of 3-3.2% of the body weight. Significant disorders of blood rheology: higher platelet ad red cell aggregation, lower erythrocyte osmotic resistance and increased blood viscosity were revealed in patients with pyoseptic urological diseases. In case plasmapheresis was included into the complex treatment, in line with the clinical efficacy of the latter a rapid normalization of the aforementioned parameters was documented by the 3-7th day of the treatment. Uroseptic patients who were exposed to plasmapheresis demonstrated improved microcirculation confirmed by isotope renography and Bengal rose which identified the improved performance of the kidneys and the liver. With account for the beneficial effect of plasmapheresis on hemorheological values in uroseptic patients, the authors suggested that for septic patients plasmapheresis substitution type should be changed.
对18例接受血浆置换治疗的脓性泌尿系统疾病患者（主要组）和18例未接受血浆置换治疗的患者（对照组）进行了某些流变学参数研究：血小板和红细胞聚集、血小板数量、血细胞比容、血沉、血液在切变率为9和105 s-1时的粘度值以及红细胞渗透抵抗力。18例患者接受了26次血浆置换治疗，血浆去除量为体重的3-3.2%。研究发现，脓性泌尿系统疾病患者存在明显的血液流变学紊乱：血小板和红细胞聚集性更高、红细胞渗透抵抗力更低以及血液粘度增加。如果将血浆置换纳入综合治疗，根据后者的临床疗效，在治疗的第3-7天可记录到上述参数迅速恢复正常。接受血浆置换治疗的尿脓毒症患者经同位素肾造影和孟加拉玫瑰红证实微循环得到改善，这表明肾脏和肝脏的功能有所改善。考虑到血浆置换对尿脓毒症患者血液流变学值的有益影响，作者建议对于脓毒症患者应改变血浆置换的类型。
