Koppensteiner R, Derfler K, Ehringer H
Department of Medical Angiology, University of Vienna, Austria.
Nephron. 1996;74(2):328-32. doi: 10.1159/000189330.
Cardiovascular complications seriously affect posttransplant survival in patients after successful renal transplantation. Abnormalities in blood rheology may contribute to these complications. Therefore, we studied the blood rheology before and during a 1-year observation period after grafting in 9 patients by serial measurements of fibrinogen, red cell aggregation, hematocrit, spontaneous platelet aggregation, and plasma viscosity. Prior to grafting, fibrinogen and red cell aggregation were found to be increased in patients on regular hemodialysis as compared with healthy controls, whereas hematocrit and platelet aggregation were markedly reduced. After successful transplantation, the platelet aggregation progressively rose together with the hematocrit, while fibrinogen and red cell aggregation remained abnormally high. Our findings suggest that abnormal blood rheology in patients with chronic renal failure does not improve in response to successful renal transplantation: fibrinogen and red cell aggregation remain abnormally high; further, the overall blood flow properties are supposed to deteriorate due to the postoperative increase in hematocrit and spontaneous platelet aggregation. Adverse rheological conditions thus resulting may contribute to the increased frequency of vascular events observed in transplanted patients.
心血管并发症严重影响肾移植成功后患者的移植后生存率。血液流变学异常可能导致这些并发症。因此，我们通过对9例患者移植后1年观察期内的纤维蛋白原、红细胞聚集、血细胞比容、自发性血小板聚集和血浆粘度进行系列测量，研究了他们的血液流变学情况。在移植前，发现接受常规血液透析的患者与健康对照组相比，纤维蛋白原和红细胞聚集增加，而血细胞比容和血小板聚集明显降低。成功移植后，血小板聚集随着血细胞比容逐渐升高，而纤维蛋白原和红细胞聚集仍异常高。我们的研究结果表明，慢性肾衰竭患者的异常血液流变学在肾移植成功后并未改善：纤维蛋白原和红细胞聚集仍异常高；此外，由于术后血细胞比容和自发性血小板聚集增加，整体血流特性可能会恶化。由此产生的不利流变学状况可能导致移植患者血管事件发生率增加。
