Larsson H, Persson S, Hedner P, Odeberg H, Gustafson A
Department of Internal Medicine, University Hospital, Lund, Sweden.
Acta Obstet Gynecol Scand. 1989;68(6):483-6.
Blood viscosity was measured in 14 healthy, menstruating women, aged 17-51 years and in 10 healthy, postmenopausal women, aged 55-64 years. The fertile women were studied once a week during a normal menstrual cycle and the postmenopausal women twice with an interval of 2 weeks. Blood viscosity was measured at natural hematocrit as well as at hematocrit 45%. In the postmenopausal women no changes in blood viscosity were found. In the fertile women, blood viscosity at hematocrit 45% was lowest at the start of the menstrual bleeding and increased to a peak at day 7 (p less than 0.01), with a similar pattern when measured at natural hematocrit. Plasma viscosity also had its lowest value at the onset of menstrual bleeding, increasing to a maximum at day 21. Changes in plasma triglycerides, but not in fibrinogen or cholesterol, seemed to contribute to this increase. Plasma factors only partly explained the variations in blood viscosity, and changes in red cell properties were also found to be of importance. The clinical significance of these rheological changes remains to be established, but at least theoretically there may be an increased risk for thromboembolism, e.g. at surgery, during days 5-15 of the cycle. In studies on blood flow and rheological conditions in fertile women, it seems advisable to standardize for time in the menstrual cycle.
对14名年龄在17 - 51岁之间处于月经期的健康女性以及10名年龄在55 - 64岁之间的绝经后健康女性进行了血液粘度测量。对处于生育期的女性在正常月经周期内每周测量一次，对绝经后女性每隔2周测量两次。在自然血细胞比容以及血细胞比容为45%时测量血液粘度。绝经后女性的血液粘度未发现变化。在处于生育期的女性中，血细胞比容为45%时的血液粘度在月经出血开始时最低，在第7天升至峰值（p < 0.01），在自然血细胞比容下测量时也有类似模式。血浆粘度在月经出血开始时也最低，在第21天升至最高。血浆甘油三酯的变化，而非纤维蛋白原或胆固醇的变化，似乎促成了这种升高。血浆因素仅部分解释了血液粘度的变化，红细胞特性的变化也被发现很重要。这些流变学变化的临床意义尚待确定，但至少在理论上，例如在手术时，在月经周期的第5 - 15天可能存在血栓栓塞风险增加的情况。在对处于生育期女性的血流和流变学状况的研究中，似乎有必要对月经周期中的时间进行标准化。
