Apsatarov E A, Andreev G N, Liubinskiĭ V L, Riudiger P E, Mukhamedzhanov G K, Ibadildin A S
Khirurgiia (Mosk). 1994 Feb(2):33-6.
The role of hemorheologic disorders in the pathogenesis of portal hypertension in shown. Rheologic disorders are characteristic of both intrahepatic and extrahepatic forms of portal hypertension. It was found that the rate of hemolysis, disorders of the lipid composition and conformation of red cell proteins is reduced in cirrhosis of the liver complicated by portal hypertension. Changes in the portal system microvessels are attended by microcirculatory disorders which are aggravated by changes in the properties of the cell membrane caused by disorders of the blood physico-chemical properties. Purposeful correction of the hemorheologic disorders has a positive effect on the rheologic parameters only in 3-4 weeks. Postoperative complications occur most frequently on the 10th-14th day. A recurrence of acute hepatic insufficiency is also noted at this time in most patients after drainage of the thoracic duct in aggravation of blood rheology. Direct changes of blood rheology in the portal system were revealed, which is a manifestation of the continuously active mechanism of the syndrome which may cause thromboses and massive hemorrhage.
血流变学紊乱在门静脉高压发病机制中的作用已得到证实。血流变学紊乱是肝内型和肝外型门静脉高压的特征。研究发现，在并发门静脉高压的肝硬化患者中，溶血速率、红细胞蛋白质脂质组成和构象紊乱均有所降低。门静脉系统微血管的变化伴随着微循环障碍，而血液理化性质紊乱导致的细胞膜特性改变会加重这种障碍。有针对性地纠正血流变学紊乱仅在3 - 4周后对血流变学参数产生积极影响。术后并发症最常发生在第10 - 14天。此时，大多数患者在胸导管引流后因血液流变学恶化而出现急性肝功能不全复发。门静脉系统血流变学的直接变化被揭示出来，这是该综合征持续活跃机制的一种表现，可能导致血栓形成和大量出血。
