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镰状细胞贫血患者的特异性血液流变学

Patient-specific blood rheology in sickle-cell anaemia.

作者信息

Li Xuejin, Du E, Lei Huan, Tang Yu-Hang, Dao Ming, Suresh Subra, Karniadakis George Em

机构信息

Division of Applied Mathematics , Brown University , Providence, RI 02912 , USA.

Department of Materials Science and Engineering , Massachusetts Institute of Technology , Cambridge, MA 02139 , USA.

出版信息

Interface Focus. 2016 Feb 6;6(1):20150065. doi: 10.1098/rsfs.2015.0065.

Abstract

Sickle-cell anaemia (SCA) is an inherited blood disorder exhibiting heterogeneous cell morphology and abnormal rheology, especially under hypoxic conditions. By using a multiscale red blood cell (RBC) model with parameters derived from patient-specific data, we present a mesoscopic computational study of the haemodynamic and rheological characteristics of blood from SCA patients with hydroxyurea (HU) treatment (on-HU) and those without HU treatment (off-HU). We determine the shear viscosity of blood in health as well as in different states of disease. Our results suggest that treatment with HU improves or worsens the rheological characteristics of blood in SCA depending on the degree of hypoxia. However, on-HU groups always have higher levels of haematocrit-to-viscosity ratio (HVR) than off-HU groups, indicating that HU can indeed improve the oxygen transport potential of blood. Our patient-specific computational simulations suggest that the HVR level, rather than the shear viscosity of sickle RBC suspensions, may be a more reliable indicator in assessing the response to HU treatment.

摘要

镰状细胞贫血(SCA)是一种遗传性血液疾病,表现出异质性细胞形态和异常流变学特性,尤其是在缺氧条件下。通过使用一个多尺度红细胞(RBC)模型,其参数来自患者特异性数据,我们对接受羟基脲(HU)治疗的SCA患者(HU治疗组)和未接受HU治疗的患者(非HU治疗组)血液的血流动力学和流变学特性进行了介观计算研究。我们确定了健康状态以及不同疾病状态下血液的剪切粘度。我们的结果表明,HU治疗根据缺氧程度改善或恶化SCA患者血液的流变学特性。然而,HU治疗组的血细胞比容与粘度比(HVR)水平总是高于非HU治疗组,这表明HU确实可以改善血液的氧运输潜力。我们基于患者特异性的计算模拟表明,HVR水平而非镰状红细胞悬浮液的剪切粘度,可能是评估对HU治疗反应的更可靠指标。

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