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不稳定型心绞痛的血液流变学异常:一种独立于危险因素谱和血管造影严重程度的关系。

Haemorrheological abnormalities in unstable angina pectoris: a relation independent of risk factor profile and angiographic severity.

作者信息

Neumann F J, Tillmanns H, Roebruck P, Zimmermann R, Haupt H M, Kübler W

机构信息

Medizinische Universitätsklinik III (Kardiologie), Ruprecht-Karls Universität Heidelberg, Federal Republic of Germany.

出版信息

Br Heart J. 1989 Dec;62(6):421-8. doi: 10.1136/hrt.62.6.421.

Abstract

Plasma viscosity, photometric erythrocyte aggregation index, and erythrocyte filterability were measured in 194 patients with coronary artery disease. Patients with unstable angina (n = 64) had a higher plasma viscosity and photometric erythrocyte aggregation index than patients with stable angina (95% confidence intervals for the mean difference: 0.052-0.100 mPa.s for plasma viscosity, and 43%-72% for the photometric erythrocyte aggregation index). Multiple regression with fibrinogen, cholesterol, high density lipoprotein cholesterol, triglycerides, blood pressure, smoking habits, coronary artery score, and left ventricular ejection fraction as independent variables showed a significant partial correlation between fibrinogen and the photometric erythrocyte aggregation index (r2 = 0.20) and plasma viscosity (r2 = 0.09), between triglycerides and plasma viscosity (r2 = 0.05), and between aortic pressure and erythrocyte filterability (r2 = 0.03). Logistic regression for unstable/stable angina with the haemorrheological variables as independent variables correctly identified 72% of the patients with stable angina and 78% of those with unstable angina. Inclusion of all the variables investigated did not substantially improve the discriminative potential of the logistic regression model. Unstable angina is associated with an impairment of blood fluidity that is essentially independent of risk factor profile and angiographic data.

摘要

对194例冠心病患者测定了血浆粘度、红细胞聚集光度指数和红细胞滤过率。不稳定型心绞痛患者(n = 64)的血浆粘度和红细胞聚集光度指数高于稳定型心绞痛患者(平均差异的95%置信区间:血浆粘度为0.052 - 0.100 mPa·s,红细胞聚集光度指数为43% - 72%)。以纤维蛋白原、胆固醇、高密度脂蛋白胆固醇、甘油三酯、血压、吸烟习惯、冠状动脉评分和左心室射血分数作为自变量进行多元回归分析,结果显示纤维蛋白原与红细胞聚集光度指数(r2 = 0.20)和血浆粘度(r2 = 0.09)、甘油三酯与血浆粘度(r2 = 0.05)、主动脉压与红细胞滤过率(r2 = 0.03)之间存在显著的偏相关。以血液流变学变量作为自变量对不稳定型/稳定型心绞痛进行逻辑回归分析,正确识别出72%的稳定型心绞痛患者和78%的不稳定型心绞痛患者。纳入所有研究变量并没有显著提高逻辑回归模型的判别能力。不稳定型心绞痛与血液流动性受损有关,这种受损基本上独立于危险因素谱和血管造影数据。

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本文引用的文献

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A new instrument for the measurement of plasma-viscosity.一种用于测量血浆粘度的新仪器。
Lancet. 1963 Aug 10;2(7302):280-1. doi: 10.1016/s0140-6736(63)90177-6.
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The phenomenon of the acute phase response.急性期反应现象
Ann N Y Acad Sci. 1982;389:39-48. doi: 10.1111/j.1749-6632.1982.tb22124.x.
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Plasma viscosity in ischemic heart disease.缺血性心脏病中的血浆粘度
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