Shin Dong Woo, Gu Ja-Yoon, Kim Jun Sik, Jung Jae-Seol, Shin Dong-Yeop, Koh Youngil, Kim Inho, Kim Hyun Kyung
Department of Laboratory Medicine and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Clin Hemorheol Microcirc. 2018;70(1):59-67. doi: 10.3233/CH-170304.
Although hyperviscosity syndrome in plasma cell dyscrasia (PCD) and thrombosis in myeloproliferative neoplasm (MPN) are major causes of morbidity and mortality, blood viscosity measurements are often underutilized.
This study aimed to characterize whether whole blood viscosity (WBV) or plasma viscosity (PV) could be predictive of hyperviscosity syndrome in PCD and could be elevated in subgroups of MPN.
A total of 75 patients with hematologic diseases: PCD (n = 26), MPN (n = 25) including polycythemia vera (P. vera) and lymphoma (n = 24) were enrolled along with 104 healthy controls. Both WBV and PV were measured using a capillary tube viscometer. Hyperviscosity syndrome was defined as having 2 or more hyperviscosity symptoms.
Patients with PCD showed significantly higher PVs at high and low shear rates when compared to healthy controls, especially in those with hyperviscosity syndrome. The sensitivity and specificity of WBV and PV in detecting hyperviscosity syndrome were 28.6% and 94.1%, and 71.4% and 66.7%, respectively. Patients with P. vera exhibited high WBV and RBC counts compared to healthy controls.
PV is predictive of hyperviscosity syndrome in PCD and WBV is elevated in patients with P. vera. It suggests that hemorheologic disturbances exist in patients with PCD and MPN and that tests of viscosity may be helpful in detecting hemorheological disturbances.
尽管浆细胞病(PCD)中的高黏滞血症和骨髓增殖性肿瘤(MPN)中的血栓形成是发病和死亡的主要原因,但血液黏度测量常常未得到充分利用。
本研究旨在明确全血黏度(WBV)或血浆黏度(PV)是否可预测PCD中的高黏滞血症,以及在MPN亚组中是否会升高。
共纳入75例血液系统疾病患者,包括PCD患者26例、MPN患者25例(包括真性红细胞增多症)和淋巴瘤患者24例,以及104例健康对照者。使用毛细管黏度计测量WBV和PV。高黏滞血症定义为有2种或更多高黏滞症状。
与健康对照者相比,PCD患者在高、低剪切率下的PV显著更高,尤其是有高黏滞血症的患者。WBV和PV检测高黏滞血症的敏感性和特异性分别为28.6%和94.1%,以及71.4%和66.7%。与健康对照者相比,真性红细胞增多症患者表现出高WBV和红细胞计数。
PV可预测PCD中的高黏滞血症,真性红细胞增多症患者的WBV升高。这表明PCD和MPN患者存在血液流变学紊乱,黏度检测可能有助于发现血液流变学紊乱。