Leschke M, Blanke H, Stellwaag M, Motz W, Strauer B E
Medizinische Einrichtungen, Universität Düsseldorf.
Dtsch Med Wochenschr. 1988 Jul 29;113(30):1175-81. doi: 10.1055/s-2008-1067789.
Plasma viscosity and erythrocyte aggregation, as the most important rheological factors in the microcirculation, and fibrinogen were measured in the blood of groups of patients in various stages of coronary-heart disease. Patients with unstable angina had viscosity and fibrinogen levels, even before any manifest infarction, that were higher than those of patients with stable angina. Plasma viscosity and hyperfibrinogenaemia (1.39 +/- 0.08 mPa.s in 48 patients and 394.4 +/- 82.7 mg/dl, respectively, in 33) were comparable to the values in patients with acute myocardial infarction (1.37 +/- 0.09 mPa.s [n = 45] and 390.2 +/- 126.9 mg/dl [n = 27], but significantly higher (P less than 0.02) than in those with stable angina (1.33 +/- 0.08 mPa.s [n = 78] and 295.3 +/- 68.6 mg/dl [n = 44], respectively). This abnormal viscosity in unstable angina plays a part in increasing myocardial ischaemia because oxygen delivery is already diminished and capillary flow slowed down. It thus contributes to progression of the angina and must be taken into account as an additional pathogenetic factor in the clinical instability.
作为微循环中最重要的流变学因素，对处于冠心病不同阶段的患者组血液进行了血浆粘度、红细胞聚集和纤维蛋白原的检测。不稳定型心绞痛患者在出现任何明显梗死之前，其粘度和纤维蛋白原水平就高于稳定型心绞痛患者。血浆粘度和高纤维蛋白原血症（48例患者分别为1.39±0.08毫帕·秒和33例患者分别为394.4±82.7毫克/分升）与急性心肌梗死患者的值相当（45例患者为1.37±0.09毫帕·秒，27例患者为390.2±126.9毫克/分升），但显著高于稳定型心绞痛患者（分别为78例患者1.33±0.08毫帕·秒和44例患者295.3±68.6毫克/分升）（P<0.02）。不稳定型心绞痛中这种异常粘度在增加心肌缺血方面起作用，因为氧输送已经减少且毛细血管血流减慢。因此，它促使心绞痛进展，并且在临床不稳定性中必须作为一个额外的致病因素加以考虑。
