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与心血管危险因素及慢性心血管疾病相关的血液流变学:一项流行病学横断面研究结果

Blood rheology associated with cardiovascular risk factors and chronic cardiovascular diseases: results of an epidemiologic cross-sectional study.

作者信息

Koenig W, Ernst E, Matrai A

机构信息

Department of Internal Medicine, University of Ulm, West Germany.

出版信息

Angiology. 1988 Nov;39(11):986-95. doi: 10.1177/000331978803901109.

Abstract

As part of an epidemiologic cross-sectional study to determine cardiovascular (CV) risk factors in the population (total serum cholesterol, smoking, blood pressure, and body weight) hemoglobin (Hb) and plasma viscosity (PV) were measured. A two-stage cluster sample of 5,312 persons, aged twenty-five to sixty-four (available 5,069) was selected from a mixed urban-rural target population of 282,279 inhabitants, from which 4,022 (79.3%) participated in the study. Patients with chronic myocardial infarction (MI), cerebral infarction (CI), angina pectoris (AP), and peripheral arterial disease (PAD) were identified by questionnaire. The results show that there is no age or sex dependency of PV in healthy participants, while hemoglobin shows the well-known sex difference. In contrast, PV increases continuously with age in the total population. In men, increased PV is found in untreated hypertension, in hypercholesterolemia, and in smokers. In women, it is raised in hypercholesterolemia and in gross obesity. Male MI patients and patients of both sexes after CI in particular show statistically significantly elevated PV. Finally, in male patients with chronic AP or patients of both sexes with PAD, PV is elevated and a tendency to higher Hb values is seen. These results confirm smaller clinical trials suggesting that blood fluidity is pathologically altered in patients with CV risk factors or diseases. Since impaired blood fluidity may worsen the hemodynamic situation, in particular in patients with limited vasomotor reserve, hemorheologic parameters may be of prognostic relevance. Therapeutic implications of these findings should be considered.

摘要

作为一项流行病学横断面研究的一部分,为了确定人群中的心血管(CV)危险因素(总血清胆固醇、吸烟、血压和体重),对血红蛋白(Hb)和血浆粘度(PV)进行了测量。从282,279名城乡混合目标人群中选取了5312名年龄在25至64岁之间的两阶段整群样本(实际可用5069人),其中4022人(79.3%)参与了研究。通过问卷调查确定患有慢性心肌梗死(MI)、脑梗死(CI)、心绞痛(AP)和外周动脉疾病(PAD)的患者。结果表明,健康参与者的血浆粘度不存在年龄或性别依赖性,而血红蛋白存在众所周知的性别差异。相比之下,在整个人口中,血浆粘度随年龄持续增加。在男性中,未经治疗的高血压、高胆固醇血症和吸烟者的血浆粘度升高。在女性中,高胆固醇血症和严重肥胖者的血浆粘度升高。男性心肌梗死患者以及男女脑梗死患者的血浆粘度尤其在统计学上显著升高。最后,在患有慢性心绞痛的男性患者或患有外周动脉疾病的男女患者中,血浆粘度升高,并且观察到血红蛋白值有升高的趋势。这些结果证实了较小规模的临床试验,表明有心血管危险因素或疾病的患者血液流动性发生了病理性改变。由于血液流动性受损可能会使血液动力学状况恶化,特别是在血管运动储备有限的患者中,血液流变学参数可能具有预后相关性。应考虑这些发现的治疗意义。

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