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心肌梗死合并急性左心室衰竭时的血液流变学紊乱

[Rheologic disorders in myocardial infarct complicated by acute left ventricular failure].

作者信息

Radzivil G G, Minsker G D

出版信息

Kardiologiia. 1984 Jan;24(1):29-33.

PMID:6700128
Abstract

Thirty-six patients with acute myocardial infarction aggravated by acute left ventricular failure (pulmonary edema, cardiogenic shock) were studied for their blood rheologic properties. The impairments of the blood rheologic properties were classified as Stage I and II syndromes of high and low blood viscosity and were characterized by a phasic nature of their course. The rheologic disorders associated with pulmonary edema and reversed cardiogenic shock were decompensated (Stage II syndrome of high blood viscosity--Stage I syndrome of low blood viscosity), but reversible following intensive rheologic therapy. Irreversible cardiogenic shock was characterized by Stage II syndrome of low blood viscosity which was intractable. In acute myocardial infarction without concomitant acute left ventricular failure, rheologic disorders were characterized by Stage I syndrome of high blood viscosity, i. e. they were compensated and did not require intensive rheologic therapy. The management of rheologic impairments attending acute left ventricular failure should be combined, the intensity of therapeutic measures, the nature of combinations and the dosage of drugs being dependent on the degree and phase of rheologic disturbances.

摘要

对36例因急性左心室衰竭(肺水肿、心源性休克)而加重的急性心肌梗死患者的血液流变学特性进行了研究。血液流变学特性的损害被分为高血粘度和低血粘度的I期和II期综合征,其病程具有阶段性。与肺水肿和逆转的心源性休克相关的流变学紊乱处于失代偿状态(高血粘度II期综合征——低血粘度I期综合征),但在强化流变学治疗后是可逆的。不可逆的心源性休克的特征是低血粘度II期综合征,这种情况难以治疗。在无合并急性左心室衰竭的急性心肌梗死中,流变学紊乱的特征是高血粘度I期综合征,即它们处于代偿状态,不需要强化流变学治疗。急性左心室衰竭伴发的流变学损害的处理应综合进行,治疗措施的强度、联合方式和药物剂量取决于流变学紊乱的程度和阶段。

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