Leschke M, Motz W, Blanke H, Strauer B E
Department of Medicine, University of Marburg, F.R.G.
J Cardiovasc Pharmacol. 1987;10 Suppl 6:S103-10.
Blood rheology was studied in 50 patients with a long history of essential hypertension, together with severe left heart hypertrophy (mass-volume relationship greater than 1.6) and angina pectoris, as well as in 17 patients with renoparenchymal hypertension. The rheologic findings were compared with those of 34 normotensive patients in whom coronary artery disease (CAD) was excluded by coronary angiography. Based on angiographic findings, the patients with essential hypertension could be differentiated into two groups: 20 hypertensive patients with normal coronary arteries and 30 hypertensive patients with coexistent CAD. In renoparenchymal hypertension, increased plasma viscosity (1.39 +/- 0.08 mPas) secondary to elevated fibrinogen levels (406.8 +/- 84.6 mg/100 ml) was found. Whole blood viscosity at low and high shear rates and the elastic component of blood were significantly more elevated in patients with renal hypertension than in patients with essential hypertension. In 30 patients with essential hypertension and coexistent CAD, higher levels of plasma viscosity (1.37 +/- 0.08 mPas, p less than 0.05) and fibrinogen (294.1 +/- 55.1 mg/100 ml, p less than 0.02) were found than in patients with essential hypertension and normal coronary arteries (1.32 +/- 0.07 mPas and 259.8 +/- 44.9 mg/100 ml, respectively). Hypertensive patients with normal coronary arteries, however, showed significantly higher levels of plasma viscosity, red blood cell aggregation, and whole blood viscosity than did normotensive controls. It is conceivable that increased blood viscosity in hypertensive patients with normal coronary arteries contributes to angina pectoris and to the reduction in coronary reserve that is observed in hypertensive patients (1).
对50例有原发性高血压病史、伴有严重左心室肥厚（质量-容积关系大于1.6）和心绞痛的患者以及17例肾实质性高血压患者进行了血液流变学研究。将这些流变学结果与34例经冠状动脉造影排除冠状动脉疾病（CAD）的血压正常患者的结果进行了比较。根据血管造影结果，原发性高血压患者可分为两组：20例冠状动脉正常的高血压患者和30例合并CAD的高血压患者。在肾实质性高血压患者中，发现由于纤维蛋白原水平升高（406.8±84.6mg/100ml）导致血浆粘度增加（1.39±0.08mPas）。肾性高血压患者的低切变率和高切变率全血粘度以及血液的弹性成分显著高于原发性高血压患者。在30例合并CAD的原发性高血压患者中，发现血浆粘度（1.37±0.08mPas，p<0.05）和纤维蛋白原（294.1±55.1mg/100ml，p<0.02）水平高于冠状动脉正常的原发性高血压患者（分别为1.32±0.07mPas和259.8±44.9mg/100ml）。然而，冠状动脉正常的高血压患者的血浆粘度、红细胞聚集和全血粘度水平显著高于血压正常的对照组。可以想象，冠状动脉正常的高血压患者血液粘度增加会导致心绞痛以及高血压患者中观察到的冠状动脉储备减少（1）。
