Caimi G, Carlisi M, Montana M, Gallà E, Lo Presti R, Hopps E, Siragusa S
Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Palermo, Italy.
Dipartimento di Scienze Psicologiche, Pedagogiche e della Formazione, Università degli Studi di Palermo, Palermo, Italy.
Clin Hemorheol Microcirc. 2018;68(1):25-34. doi: 10.3233/CH-170267.
The hemorheological profile in multiple myeloma (MM) has been extensively studied. Our investigation regarded the behavior of whole-blood viscosity, plasma viscosity and erythrocyte deformability in MM. We enrolled 24 MM patients; 13 of them had been recently diagnosed and were at the initial stage of therapy, 6 were on consolidation/conservation therapy and 5 had achieved a complete remission. On fasting venous blood we evaluated whole-blood and plasma viscosity at high and low shear rates, haematocrit, the ratios between whole-blood viscosity (at high and low shear rate) and haematocrit×100, the ratio between plasma viscosity at low and high shear rate and the erythrocyte deformability examined by using laser diffractometry and expressed as elongation index. A significant increase in plasma viscosity at low shear rate and a marked decrease in haematocrit were observed in MM patients compared with normal controls. Also the ratio between the high shear rate whole-blood viscosity and haematocrit ×100 and the ratio between the low and high shear rate plasma viscosity were significantly increased in MM patients. A significant decrease in erythrocyte deformability, especially at low shear stresses, was found. We discuss some hypotheses that might explain the behavior of red blood cell deformability in MM, considering that its impairment, in addition to the increase of plasma viscosity, can alter the microcirculatory flow in these patients.
多发性骨髓瘤（MM）的血液流变学特征已得到广泛研究。我们的调查关注了MM患者全血粘度、血浆粘度和红细胞变形性的表现。我们纳入了24例MM患者；其中13例为近期诊断且处于治疗初期，6例正在进行巩固/维持治疗，5例已实现完全缓解。我们采集空腹静脉血，评估了高、低剪切率下的全血粘度和血浆粘度、血细胞比容、全血粘度（高、低剪切率）与血细胞比容×100的比值、低剪切率与高剪切率血浆粘度的比值，以及使用激光衍射法检测并表示为伸长指数的红细胞变形性。与正常对照组相比，MM患者低剪切率下的血浆粘度显著升高，血细胞比容显著降低。MM患者高剪切率全血粘度与血细胞比容×100的比值以及低剪切率与高剪切率血浆粘度的比值也显著升高。发现红细胞变形性显著降低，尤其是在低剪切应力下。我们讨论了一些可能解释MM患者红细胞变形性表现的假设，考虑到其损害除了会增加血浆粘度外，还会改变这些患者的微循环血流。
