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发热性中性粒细胞减少期对恶性肿瘤患者血浆黏度的影响。

Influence of febrile neutropenia period on plasma viscosity at malignancy.

作者信息

Tek Ibrahim, Toprak Selami Kocak, Hasdemir Efe, Rahatli Samed, Yesilkaya Aysegül

机构信息

Department of Medical Oncology, Medicana International Hospital Cancer Center, 06520 Ankara, Turkey.

出版信息

ScientificWorldJournal. 2013 Oct 27;2013:507270. doi: 10.1155/2013/507270. eCollection 2013.

Abstract

Cancer, chemotherapy, and infections all together make changes in blood rheology and may affect the defense mechanisms by changing the thrombocyte function and endothelial cell. We have examined changes of blood rheology on plasma viscosity to put on probable following criteria for starting the treatment of febrile neutropenia immediately. A total of 27 postchemotherapy patients (16 males and 11 females) with febrile neutropenia diagnosed according to international guidelines have been included into the study. The plasma viscosity of the patients whose febrile neutropenia has been successfully treated was also measured to assess the impact of the duration of neutropenia on viscosity. The plasma viscosities of the patients were significantly higher during neutropenic episode than in nonneutropenic state (P = 0.006) except for alkaline phosphatase. All study parameters, particularly acute phase reactants, were statistically similar during both states. In the correlation of analysis with study parameters and stages, significant correlation was not observed between plasma viscosity alteration and leukocyte-neutrophil alteration, also other study parameters. We have demonstrated significantly elevated plasma viscosity in our patients during febrile neutropenic episode. Despite normal values of various parameters known to trigger plasma viscosity, particularly fibrinogen, it can be easily argued that the main mechanism may be the endothelial injury during infectious process and immune response mediated microcirculatory blood flow alterations.

摘要

癌症、化疗和感染都会改变血液流变学,并可能通过改变血小板功能和内皮细胞来影响防御机制。我们研究了血浆粘度的血液流变学变化,以提出可能的标准,以便立即开始治疗发热性中性粒细胞减少症。根据国际指南诊断为发热性中性粒细胞减少症的27例化疗后患者(16例男性和11例女性)被纳入研究。还测量了发热性中性粒细胞减少症已成功治疗的患者的血浆粘度,以评估中性粒细胞减少持续时间对粘度的影响。除碱性磷酸酶外,患者在中性粒细胞减少发作期间的血浆粘度显著高于非中性粒细胞减少状态(P = 0.006)。在两种状态下,所有研究参数,特别是急性期反应物,在统计学上相似。在与研究参数和阶段的相关性分析中,未观察到血浆粘度改变与白细胞-中性粒细胞改变以及其他研究参数之间存在显著相关性。我们已经证明,在发热性中性粒细胞减少发作期间,我们的患者血浆粘度显著升高。尽管已知触发血浆粘度的各种参数(特别是纤维蛋白原)值正常,但很容易认为主要机制可能是感染过程中的内皮损伤和免疫反应介导的微循环血流改变。

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