Furukawa Koji, Abumiya Takeo, Sakai Keiji, Hirano Miki, Osanai Toshiya, Shichinohe Hideo, Nakayama Naoki, Kazumata Ken, Hida Kazutoshi, Houkin Kiyohiro
Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan; Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan.
Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
J Stroke Cerebrovasc Dis. 2016 Nov;25(11):2762-2769. doi: 10.1016/j.jstrokecerebrovasdis.2016.07.031. Epub 2016 Aug 5.
High blood viscosity causes blood stagnation and subsequent pathological thrombotic events, resulting in the development of ischemic stroke. We hypothesize that the contribution of blood viscosity may differ among ischemic stroke subtypes based on specific pathological conditions. We tried to verify this hypothesis by measuring blood viscosity in acute ischemic stroke patients using a newly developed electromagnetic spinning sphere (EMS) viscometer.
Measurements in acute ischemic stroke patients were performed 4 times during admission and data were compared with those obtained from 100 healthy outpatient volunteers.
We enrolled 92 patients (cardioembolism: 25, large artery atherosclerosis: 42, and small artery occlusion [SAO]: 25) in this study. Comparisons of blood viscosity between the ischemic stroke subgroups and control group revealed that blood viscosity at the date of admission was significantly higher in the SAO group (5.37 ± 1.11 mPa⋅s) than in the control group (4.66 ± .72 mPa⋅s) (P < .01). Among all subtype groups showing a reduction in blood viscosity after 2 weeks, the SAO group showed the highest and most significant reduction, indicating that SAO patients had the most concentrated blood at the onset.
Blood viscosity was significantly increased in the SAO group at the date of admission, which indicated the contribution of dehydration to the onset of ischemic stroke. The importance of dehydration needs to be emphasized more in the pathogenesis of SAO. The clinical application of the EMS viscometer is promising for understanding and differentiating the pathogenesis of ischemic stroke.
高血液粘度会导致血液淤滞及随后的病理性血栓形成事件，进而引发缺血性中风。我们推测，基于特定的病理状况，血液粘度在缺血性中风各亚型中的作用可能有所不同。我们试图通过使用新开发的电磁旋转球体（EMS）粘度计测量急性缺血性中风患者的血液粘度来验证这一假设。
在急性缺血性中风患者入院期间进行4次测量，并将数据与100名健康门诊志愿者的数据进行比较。
本研究纳入了92例患者（心源性栓塞：25例，大动脉粥样硬化：42例，小动脉闭塞[SAO]：25例）。缺血性中风亚组与对照组之间的血液粘度比较显示，SAO组入院时的血液粘度（5.37±1.11mPa·s）显著高于对照组（4.66±0.72mPa·s）（P<0.01）。在所有2周后血液粘度降低的亚型组中，SAO组的降低幅度最大且最显著，这表明SAO患者在发病时血液最为浓缩。
SAO组入院时血液粘度显著升高，这表明脱水对缺血性中风发病有影响。在SAO的发病机制中，脱水的重要性需要更加强调。EMS粘度计的临床应用有望用于理解和区分缺血性中风的发病机制。
