Staub N C
J Lab Clin Med. 1981 Sep;98(3):311-22.
Although research on microcirculation has expanded rapidly in the last 20 years, clinical evaluation of microcirculation, as an entity, has not achieved any status in the United States. Three aspects of microcirculation are presented, wherein clinical applications exist or on the verge of existing. Biomicroscopy is the direct observation of, and measurements within, the microcirculation is superficial areas of the body. Not only can the pattern of the microcirculation be examined and related to microcirculatory function but also the intravascular relationships among red cells, leukocytes, and platelets can be studied. Rheology includes measurement of the interactions among plasma and cellular elements during flow within the microcirculation. Unfortunately, rheologic factors are generally ignored in thinking about hemodynamics. The concept of the optimal hematocrit has great clinical relevance in both acute and chronic disease. Transvascular fluid and solute exchange can be evaluated in the body as a whole and in individual organs by relatively noninvasive techniques. Such evaluations provide useful information about the natural progress and the effect of treatment of a variety of serious diseases. Microcirculation, as an entity, is a quantitative science in its own right and ought to be actively applied in clinical medicine.
尽管在过去20年里，关于微循环的研究迅速发展，但作为一个整体，微循环的临床评估在美国尚未取得任何地位。本文介绍了微循环的三个方面，在这些方面临床应用已经存在或即将出现。生物显微镜检查是对身体浅表部位微循环进行直接观察和测量。不仅可以检查微循环模式并将其与微循环功能相关联，还可以研究红细胞、白细胞和血小板之间的血管内关系。流变学包括测量微循环内血流过程中血浆与细胞成分之间的相互作用。不幸的是，在考虑血液动力学时，流变学因素通常被忽视。最佳血细胞比容的概念在急性和慢性疾病中都具有重要的临床意义。通过相对无创的技术可以在整个身体和各个器官中评估跨血管液体和溶质交换。此类评估为各种严重疾病的自然进展和治疗效果提供了有用信息。作为一个整体，微循环本身就是一门定量科学，应该积极应用于临床医学。
