Volger E
Wien Med Wochenschr. 1986;136 Spec No:5-10.
Diabetics mostly display a deterioration of blood flow properties. Studies of various hemorheological factors in 163 diabetics (96 females, 67 males; 52 subjects with uncomplicated and 49 with proliferative retinopathy) disclosed in comparison to 79 matched controls: Concentrations of macromolecular proteins, especially of fibrinogen, were raised independently of actual diabetic metabolic situation; this was linked with an increase in plasma viscosity and in erythrocyte aggregation, specially pronounced in patients with renal affection. Erythrocyte flexibility assessed by filtration testing was deteriorated in dependence of metabolic control, impairment increasing in patients with progressing diabetic proliferative retinopathy. Duration of diabetes, type of diabetes and of treatment exert only indirect influence on blood rheology. Risk factors such as hypertension, arteriosclerosis and smoking have an aggravating effect. The complex disturbances of blood fluidity can contribute to the development of microcirculatory blood flow disorders, whereby, of course platelet hyperreactivity and hypercoagulation come into play, too. Especially a good diabetes control is a premise for an efficient blood flow promoting rheologic therapy.
糖尿病患者大多表现出血流特性的恶化。对163名糖尿病患者（96名女性，67名男性；52名无并发症患者和49名增殖性视网膜病变患者）的各种血液流变学因素进行研究后发现，与79名匹配的对照组相比：大分子蛋白质，尤其是纤维蛋白原的浓度升高，且与实际糖尿病代谢状况无关；这与血浆粘度增加和红细胞聚集增加有关，在有肾脏病变的患者中尤为明显。通过过滤试验评估的红细胞柔韧性随代谢控制情况而恶化，在糖尿病增殖性视网膜病变进展的患者中损害加剧。糖尿病病程、糖尿病类型和治疗方式仅对血液流变学有间接影响。高血压、动脉硬化和吸烟等危险因素具有加重作用。血液流动性的复杂紊乱会导致微循环血流障碍的发展，当然，血小板高反应性和高凝状态也会起作用。特别是良好的糖尿病控制是有效的促进血流的流变学治疗的前提。
