Heilmann L, Schmid-Schönbein H
Stadtkrankenhaus Hessenklinik, Rüsselsheim.
Klin Wochenschr. 1990 Jun 5;68(11):559-64. doi: 10.1007/BF01667148.
Forty-five women with preeclampsia and 39 woman with chronic hypertension in pregnancy were studied by catheterization of the superior vena cava and by impedance cardiography before therapy was started. An initial hemorrheology and hemostaseologic protocol was prepared which included hematocrit, erythrocyte aggregation, erythrocyte deformability, plasma viscosity, colloid osmotic pressure, serum osmolality, uric acid, fibronectin, antithrombin III and fibrinogen. The hematocrit and the peripheral resistance were greater in preeclampsia than in essential hypertension. Moreover, preeclamptic patients showed a significantly lower cardiac output and central venous pressure than women with chronic hypertension. On the other hand, the plasma viscosity of women with essential hypertension increased, whereas patients with preeclampsia showed a lower erythrocyte deformability and a higher concentration of leukocytes. Finally, volume expansion with Hydroxyethyl-starch appears to be of therapeutic benefit for hypertensive patients with low cardiac output.
在开始治疗前,通过上腔静脉插管和阻抗心动图对45例子痫前期患者和39例妊娠合并慢性高血压患者进行了研究。制定了初始血液流变学和止血学方案,包括血细胞比容、红细胞聚集、红细胞变形性、血浆粘度、胶体渗透压、血清渗透压、尿酸、纤连蛋白、抗凝血酶III和纤维蛋白原。子痫前期患者的血细胞比容和外周阻力高于原发性高血压患者。此外,子痫前期患者的心输出量和中心静脉压明显低于慢性高血压女性。另一方面,原发性高血压女性的血浆粘度增加,而子痫前期患者的红细胞变形性较低,白细胞浓度较高。最后,对于心输出量低的高血压患者,羟乙基淀粉扩容似乎具有治疗益处。