Rampling M W, Whittingstall P, Martin G, Bignall S, Rivers R P, Lissauer T J, Bailey P C
Department of Physiology and Biophysics, St. Mary's Hospital Medical School, London, UK.
Pediatr Res. 1989 May;25(5):457-60. doi: 10.1203/00006450-198905000-00006.
A number of studies have indicated that the rheologic properties of neonatal blood are different from those of the adult. The frequent administration of blood components to the neonate during intensive care make it important that these differences be established and their causes understood. The purpose of this study was to make a detailed comparison of the rheologic properties of neonatal and adult blood, with particular emphasis on low shear rate viscosity and rouleaux-related phenomena. The viscometric data was obtained from seven preterm (PT) and 18 normal term (NT) babies and compared with those from 18 adults (A). In the present study, viscometry was performed over a wide range of shear rates, from about 0.3 to 130 s-1, and the low shear rate data were compared with direct measurement of rouleaux formation using the Myrenne Erythrocyte Aggregometer. A major factor leading to the viscometric differences observed was the high hematocrit common in the newborn (46.8 +/- 2.1% PT, 52.8 +/- 6.1% NT, 44.1 +/- 2.5% A males, 40.5 +/- 1.9% A females). However, this tended to be compensated for by the lower plasma viscosity (1.05 +/- 0.07 mPas PT, 1.23 +/- 0.14 mPas NT, 1.34 +/- 0.08 mPas A--no sex difference) and reduced rouleaux formation observed in the newborn and more marked in the preterm baby. The lowered levels of red cell aggregation were found not to be due to cellular differences between the adults and the babies but rather to differing plasma components. The presence of the fetal variant of fibrinogen and low levels of immunoglobulins, especially IgM and IgA, are likely to be of particular importance.
多项研究表明，新生儿血液的流变学特性与成年人不同。在重症监护期间频繁给新生儿输注血液成分，因此明确这些差异并了解其原因很重要。本研究的目的是详细比较新生儿和成年人血液的流变学特性，特别强调低剪切速率粘度和与红细胞缗钱状形成相关的现象。粘度测定数据取自7名早产儿（PT）和18名足月儿（NT），并与18名成年人（A）的数据进行比较。在本研究中，粘度测定是在约0.3至130 s-1的广泛剪切速率范围内进行的，低剪切速率数据与使用迈伦红细胞聚集仪直接测量红细胞缗钱状形成的结果进行了比较。观察到的粘度差异的一个主要因素是新生儿常见的高血细胞比容（PT为46.8±2.1%，NT为52.8±6.1%，成年男性A为44.1±2.5%，成年女性A为40.5±1.9%）。然而，这往往被较低的血浆粘度（PT为1.05±0.07 mPas，NT为1.23±0.14 mPas，A为（无性别差异）1.34±0.08 mPas）以及新生儿中观察到的红细胞缗钱状形成减少（在早产儿中更明显）所抵消。发现红细胞聚集水平降低不是由于成年人和婴儿之间的细胞差异，而是由于血浆成分不同。纤维蛋白原胎儿变体的存在以及免疫球蛋白水平较低，尤其是IgM和IgA，可能特别重要。
