Dormandy J A
Int J Cardiol. 1987 Feb;14(2):213-9. doi: 10.1016/0167-5273(87)90010-6.
One of the crucial determinants of tissue perfusion is the flow behaviour, that is the rheology, of the blood itself. In the microcirculation the most important factor is the ability of the cellular components of blood to deform as they pass through the narrower capillary passages. Until recently, it was thought that the deformability of the red cells was more important than that of the white cells, because of their numerical superiority. Recently, the flow behaviour of white cells is thought to be at least equally important. There is now extensive epidemiological, experimental and clinical evidence linking the microrheological properties of blood to tissue ischaemia. The possible role of serotonin in altering haemorrheology is inferred from studies using specific serotonin antagonists. Ketanserin, given orally has been shown to improve blood filterability in patients with myocardial infarction and intermittent claudication. There was also a specific effect on white cells. It is postulated on the basis of these and other experiments that in situations of tissue ischaemia, when there is a local increase in plasma serotonin levels, the deleterious effect of serotonin on blood cell rheology may have an important role in perpetuating the ischaemia.
组织灌注的关键决定因素之一是血液自身的流动行为，即血液流变学。在微循环中，最重要的因素是血液中的细胞成分在通过较狭窄的毛细血管通道时发生变形的能力。直到最近，由于红细胞数量上的优势，人们认为红细胞的可变形性比白细胞更为重要。近来，白细胞的流动行为被认为至少同等重要。现在有大量的流行病学、实验和临床证据将血液的微观流变学特性与组织缺血联系起来。使用特定的5-羟色胺拮抗剂进行的研究推断出5-羟色胺在改变血液流变学方面可能发挥的作用。口服酮色林已被证明可改善心肌梗死和间歇性跛行患者的血液滤过性。对白细胞也有特定作用。基于这些及其他实验推测，在组织缺血的情况下，当局部血浆5-羟色胺水平升高时，5-羟色胺对血细胞流变学的有害作用可能在使缺血持续存在方面发挥重要作用。
