心脏X综合征中的血液流变学功能障碍。

Hemorheological dysfunction in cardiac syndrome X.

作者信息

Kilic-Toprak Emine, Yaylali Olga, Yaylali Yalin Tolga, Ozdemir Yasin, Yuksel Dogangun, Senol Hande, Sengoz Tarık, Bor-Kucukatay Melek

机构信息

a Faculty of Medicine, Department of Physiology , Pamukkale University , Kinikli , Denizli, Turkey.

b Faculty of Medicine, Department of Nuclear Medicine , Pamukkale University , Kinikli , Denizli, Turkey.

出版信息

Acta Cardiol. 2018 Jun;73(3):257-265. doi: 10.1080/00015385.2017.1373967. Epub 2017 Sep 11.

DOI:10.1080/00015385.2017.1373967

PMID:28889793

Abstract

BACKGROUND

Cardiac syndrome X (CSX) is often described as angina or angina-like chest pain with a normal coronary arteriogram, yet the underlying pathophysiological mechanisms have not been fully elucidated. The aim of the current study was to determine alterations in blood rheology (erythrocyte aggregation and deformability, plasma viscosity - PV) in patients with CSX.

METHODS

The study comprised 26 CSX patients (55.77 ± 12.33 years) and 37 age- and sex-matched (56.32 ± 11.98 years) healthy controls. Erythrocyte aggregation and deformability were measured by an ektacytometer and PV with a rotational viscometer.

RESULTS

Erythrocyte deformability measured at 1.69 and 3.00 Pa was lower in the CSX patients compared to the controls (p = .0001 and .017, respectively). Erythrocyte aggregation index (AI) (72.758 ± 7.65 vs. 66.483 ± 6.63, p = .002) and PV measured at a shear rate of 375 s (1.932 ± 0.225 vs. 1.725 ± 0.331, p = .019) were significantly higher in patients with CSX. When AI, RDW and erythrocyte deformability measured at 1.69 Pa were evaluated together, it was observed that the increase in AI and RDW augments the risk of having CSX (OR: 1.2 and 2.65, respectively), while the rise in deformability decreases this risk (OR = 0.02).

CONCLUSIONS

Hemorheological impairments are associated with CSX.

摘要

背景

心脏综合征X（CSX）常被描述为冠状动脉造影正常情况下的心绞痛或类心绞痛样胸痛，但其潜在的病理生理机制尚未完全阐明。本研究的目的是确定CSX患者血液流变学（红细胞聚集性和变形性、血浆黏度 - PV）的改变。

方法

本研究纳入了26例CSX患者（年龄55.77 ± 12.33岁）和37例年龄及性别匹配的健康对照者（年龄56.32 ± 11.98岁）。用激光衍射红细胞变形仪测量红细胞变形性，用旋转黏度计测量血浆黏度。

结果

与对照组相比，CSX患者在1.69和3.00 Pa时测量的红细胞变形性较低（p分别为0.0001和0.017）。CSX患者的红细胞聚集指数（AI）（72.758 ± 7.65对66.483 ± 6.63，p = 0.002）和在剪切速率为375 s时测量的血浆黏度（1.932 ± 0.225对1.725 ± 0.331, p = 0.019）显著更高。当一起评估AI、红细胞分布宽度（RDW）和在1.69 Pa时测量的红细胞变形性时，观察到AI和RDW的增加会增加患CSX的风险（OR分别为1.2和2.65），而变形性的增加会降低这种风险（OR = 0.02）。