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原发性和继发性雷诺现象的血液流变学特征。微血管病变的影响。

Hemorheological profile in primary and secondary Raynaud's phenomenon. Influence of microangiopathy.

作者信息

Vayá Amparo, Alis Rafael, Romagnoli Marco, Todolí Jose, Calvo Javier, Ricart Jose M

机构信息

Hemorheology and Hemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain.

Universitary Research Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia, "San Vicente Mártir", Valencia, Spain.

出版信息

Clin Hemorheol Microcirc. 2014;56(3):259-64. doi: 10.3233/CH-131723.

Abstract

Raynaud's phenomenon (RP) is an episodic peripheral circulatory disorder characterized by local artery spams in subjects exposed to cold or emotional stress. It is not well-established whether RP patients show an altered rheological profile, mostly due to patient classification and clinical severity. We aimed to compare the hemorheological profile in patients with primary and secondary RP with a healthy control group. Eighteen primary RP, 22 secondary RP and 22 healthy controls, were included in the study. RP patients were also divided according to the presence of digital ulcers (7 with, 33 without). Biochemical and hemorheological variables were analyzed, including glucose, triglycerides, total-cholesterol, immunoglobulins, fibrinogen, plasma viscosity, erythrocyte aggregation, erythrocyte deformability and blood viscosity. Age was higher in secondary RP as compared with primary (p = 0.049), while glucose, triglycerides IgA, IgG and plasma viscosity were higher in secondary RP than in healthy subjects (p < 0.05). RP patients with digital ulcers presented higher IgA (p = 0.012), lower erythrocyte aggregation time (p = 0.008) and a trend for higher fibrinogen levels and plasma viscosity (p = 0.064, p = 0.069, respectively). The results of the present study indicate that secondary RP patients show a mild impairment of the rheological profile that aggravates with microangiopathy severity.

摘要

雷诺现象(RP)是一种发作性外周循环障碍,其特征为暴露于寒冷或情绪应激的个体出现局部动脉痉挛。RP患者是否表现出血流变学特征改变尚不完全明确,这主要归因于患者分类和临床严重程度。我们旨在比较原发性和继发性RP患者与健康对照组的血液流变学特征。本研究纳入了18例原发性RP患者、22例继发性RP患者和22例健康对照者。RP患者还根据是否存在指端溃疡进行了分组(7例有溃疡,33例无溃疡)。分析了生化和血液流变学变量,包括血糖、甘油三酯、总胆固醇、免疫球蛋白、纤维蛋白原、血浆黏度、红细胞聚集、红细胞变形能力和血液黏度。继发性RP患者的年龄高于原发性患者(p = 0.049),而继发性RP患者的血糖、甘油三酯、IgA、IgG和血浆黏度高于健康受试者(p < 0.05)。有指端溃疡的RP患者IgA水平较高(p = 0.012),红细胞聚集时间较短(p = 0.008),纤维蛋白原水平和血浆黏度有升高趋势(分别为p = 0.064和p = 0.069)。本研究结果表明,继发性RP患者表现出轻度血液流变学特征损害,且随着微血管病变严重程度加重而加剧。

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