Tripette Julien, Nguyen Linh-Chi, Allard Louise, Robillard Pierre, Soulez Gilles, Cloutier Guy
Laboratory of Biorheology and Medical Ultrasonics, Research Center, University of Montreal Hospital (CRCHUM), Québec, Canada.
Laboratory of Biorheology and Medical Ultrasonics, Research Center, University of Montreal Hospital (CRCHUM), Québec, Canada; Institute of Biomedical Engineering, University of Montreal, Québec, Canada.
PLoS One. 2015 Apr 23;10(4):e0124712. doi: 10.1371/journal.pone.0124712. eCollection 2015.
Diabetic patients present higher level of red blood cell (RBC) aggregation contributing to the development of vascular complications. While it has been suggested that this hematology/rheology parameter could bring additional prognostic information for the management of those patients, RBC aggregation screening is not included as a clinical practice. Most medical centers are not equipped to measure properly this parameter, although sedimentation tests can bring some indication. Here, we aimed at evaluating the feasibility of using ultrasound to assess in-vivo hyper-aggregation in type 2 diabetic patients.
Seventeen diabetic patients and 15 control subjects underwent ultrasound measurements of RBC aggregation in both cephalic and great saphenous veins. Non-invasive in-vivo ultrasound measurements were performed using a newly developed cellular imaging technique, the structure factor size and attenuation estimator (SFSAE). Comparisons with an ex-vivo gold standard rheometry technique were done, along with measurements of pro-aggregating plasma molecule concentrations.
In-vivo RBC aggregation was significantly higher in diabetic patients compared with controls for cephalic vein measurements, while a trend (p = 0.055) was noticed in the great saphenous vein. SFSAE measurements were correlated with gold standard in-vitro measures, fibrinogen and C-reactive protein plasma concentrations.
RBC aggregation can be measured in-vivo in diabetic patients using ultrasound. Prospective studies are needed to determine whether the SFSAE method could help clinicians in the early management of vascular complications in this patient population.
糖尿病患者的红细胞（RBC）聚集水平较高，这促使血管并发症的发生。虽然有人提出，这一血液学/流变学参数可为这些患者的管理提供额外的预后信息，但红细胞聚集筛查并未纳入临床实践。大多数医疗中心没有适当测量该参数的设备，尽管沉降试验可提供一些线索。在此，我们旨在评估使用超声评估2型糖尿病患者体内高聚集性的可行性。
17名糖尿病患者和15名对照受试者接受了头静脉和大隐静脉红细胞聚集的超声测量。使用新开发的细胞成像技术——结构因子大小和衰减估计器（SFSAE）进行非侵入性体内超声测量。与体外金标准流变学技术进行比较，并测量促聚集血浆分子浓度。
头静脉测量中，糖尿病患者的体内红细胞聚集显著高于对照组，而在大隐静脉中观察到一种趋势（p = 0.055）。SFSAE测量结果与金标准体外测量、纤维蛋白原和C反应蛋白血浆浓度相关。
使用超声可在糖尿病患者体内测量红细胞聚集。需要进行前瞻性研究，以确定SFSAE方法是否有助于临床医生对该患者群体的血管并发症进行早期管理。
