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[重度妊娠中毒症的血液流变学检查结果]

[Hemorrheologic findings in severe gestosis].

作者信息

Heilmann L

机构信息

Zentrum für Frauenheilkunde, Essen.

出版信息

Geburtshilfe Frauenheilkd. 1987 Nov;47(11):764-9. doi: 10.1055/s-2008-1036042.

Abstract

On the basis of the hemorrheologic and hemodynamic data of 30 severe gestoses the importance of rheology in the diagnosis and treatment of these conditions is discussed. It was found that the gestoses can occur with a variety of clinical phenomena (HELLP syndrome, hypervolemic gestosis). The classic picture comprises hemoconcentration, increased erythrocyte aggregation, low central venous pressure and low-normal cardiac output with increased blood viscosity. Depending on the condition of the microcirculation, laboratory values can fluctuate considerably. The mean antithrombin-III value was not subnormal, but the fibronectin value was high. The causes of the increased fibronectin values are still not clear. It seemed important that with a hematocrit of over 38% and an erythrocyte aggregation over 28(-) there was a high probability of the fetus being at risk. Erythrocyte deformability is reduced. The reasons for this still have to be identified. Changes in the ion transport system on the erythrocyte membrane, with accumulation of sodium and calcium inside the cell, are discussed. Additionally, leukocytosis causes an impairment of blood flow characteristics.

摘要

基于30例重度妊娠中毒症患者的血液流变学和血液动力学数据,探讨了流变学在这些病症诊断和治疗中的重要性。研究发现,妊娠中毒症可伴有多种临床现象(如HELLP综合征、高血容量性妊娠中毒症)。典型症状包括血液浓缩、红细胞聚集增加、中心静脉压降低以及心输出量略低伴血液粘度增加。根据微循环状况,实验室检查值可能会有很大波动。抗凝血酶III的平均水平并未低于正常,但纤维连接蛋白水平较高。纤维连接蛋白水平升高的原因尚不清楚。似乎重要的是,当血细胞比容超过38%且红细胞聚集超过28(-)时,胎儿处于危险中的可能性很高。红细胞变形能力降低,其原因仍有待确定。文中讨论了红细胞膜上离子转运系统的变化,即细胞内钠和钙的积累。此外,白细胞增多会导致血流特性受损。

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