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[治疗性血小板单采术——对血液流变学参数的影响]

[Therapeutic thrombocytapheresis--effect on hemorheologic parameters].

作者信息

Langer R, Gross D, Mansouri Taleghani B, Wiebecke D, Henrich H A

机构信息

Abteilung Experimentelle Chirurgie, Chirurgische Universitätsklinik, Würzburg, Deutschland.

出版信息

Beitr Infusionsther Transfusionsmed. 1997;34:265-72.

PMID:9417347
Abstract

Common features of all myeloproliferative diseases (CMPE) are a markedly increased number of platelets and restrictions in the subjective feeling of the patients, comprising symptoms like nausea, headache, sensory deficits and transient paresis. Meanwhile, it has been shown that platelet pheresis (mTD) does not only reduce platelet counts sufficiently but also results in an impressive relief of the subjective complaints. To test the part that rheological mechanisms play hereby, relevant rheological parameters in the blood of 22 CMPE patients and of 8 healthy platelet donors as controls were analyzed before and after treatment with an AS-104 cell separator. Concerning the viscosity of whole blood und the filterability of erythrocytes, there was seen neither a difference between the patients and the controls, nor before and after mTD. As a result of treatment of patients, the moderately raised plasma viscosity was normalized, whereas the aggregation of erythrocytes was significantly lowered. It is concluded that there is an influence of hemorheological conditions on the patient's subjective feeling. These would originate in neurological dysfunctions caused by CMPE-induced restrictions in cortical microcirculation. The erythrocyte aggregation, lowered by mTD, would cause an improvement of microcirculatory fluidity and would, in consequence, abolish the neurological symptoms.

摘要

所有骨髓增殖性疾病的共同特征(CMPE)是血小板数量显著增加以及患者主观感受受限,包括恶心、头痛、感觉障碍和短暂性轻瘫等症状。同时,已表明血小板单采术(mTD)不仅能充分降低血小板计数,还能显著缓解主观不适。为了测试流变学机制在此过程中所起的作用,在用AS - 104细胞分离器治疗前后,对22例CMPE患者和8名健康血小板捐献者作为对照的血液中的相关流变学参数进行了分析。关于全血粘度和红细胞过滤性,患者与对照组之间以及mTD治疗前后均未发现差异。患者治疗后,中度升高的血浆粘度恢复正常,而红细胞聚集显著降低。得出的结论是,血液流变学状况对患者的主观感受有影响。这些影响源于CMPEPE引起皮层微循环受限所导致的神经功能障碍。mTD降低的红细胞聚集会改善微循环流动性,从而消除神经症状。

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