Rogers F, Dunn R, Barrett J, Merlotti G, Sheaff C, Nolan P
Circ Shock. 1985;15(2):105-10.
Normal red cells are flexible and can thus negotiate small capillaries with ease. Impaired red cell deformability (RCD) has been found in patients with uremia, peripheral vascular disease, and diabetes. This study was performed in order to determine if impaired RCD is present during sepsis. The RCD of citrated whole blood (WB) and citrated buffy coat-poor whole blood (BCP) from ten septic patients was compared to ten age-, sex-, and race-matched control patients. The samples were passed through polycarbonate 5 micron pore filters at -10 cm H2O pressure according to the technique of Reid. A red cell deformability index was calculated for each patient by multiplying the volume of blood flowing through the apparatus in a 1-minute period by the hematocrit. The results show very highly significant decreases of flow in both the WB and BCP blood in the septic group. Alterations in flow in the WB can be explained on the basis of changes in the buffy coat fraction and/or the red cell deformability. A decrease in flow in the BCP blood can be explained in terms of a diminished deformability of the red cells themselves. This increased rigidity of the red cells could, in part, explain the AV shunting and decreased microcirculatory flow seen in the septic state.
正常红细胞具有柔韧性，因此能够轻松通过小毛细血管。在尿毒症、外周血管疾病和糖尿病患者中已发现红细胞变形性（RCD）受损。进行这项研究是为了确定脓毒症期间是否存在RCD受损。将10名脓毒症患者的枸橼酸化全血（WB）和枸橼酸化少白细胞全血（BCP）的RCD与10名年龄、性别和种族匹配的对照患者进行比较。根据Reid的技术，将样本在-10 cm H2O压力下通过聚碳酸酯5微米孔径的过滤器。通过将1分钟内流经该装置的血液体积乘以血细胞比容，为每位患者计算红细胞变形性指数。结果显示，脓毒症组的WB和BCP血液中的血流均显著降低。WB中血流的改变可以根据白细胞层部分的变化和/或红细胞变形性来解释。BCP血液中血流的减少可以用红细胞本身变形性降低来解释。红细胞这种增加的刚性可能部分解释了脓毒症状态下所见的动静脉分流和微循环血流减少。
