Laghi Pasini F, Capecchi P L, Di Perri T
Istituto di Clinica Medica Generale e Terapia Medica, Università degli Studi, Siena.
Minerva Cardioangiol. 1998 Apr;46(4):109-17.
Blood viscosity represents the internal friction of the blood, in other terms, its resistance to be deformed and to flow under a tangential force. This function is conditioned by the intrinsic characteristics of blood and the geometry of the system in which flow occurs. Thus, any in vitro (or ex vivo) system of measurement of blood viscosity represents a relatively approximate evaluation of the ratio between intertial forces and viscous resistance. However, the possibility of measuring blood viscosity in a reproducible way provided the opportunity of identifying some clinical conditions associated with a worsening in rheologic parameters. Thus, "primary" and "secondary" hyperviscosity syndromes have been defined, on the basis of the pathogenetic responsibility of rheologic or hemodynamic factors, respectively. The possibility of performing in vitro measurement of blood viscosity provided the opportunity of planning several clinical pharmacology studies with theoretically active drugs. On such a basis, the rationale has arisen for a "rheologic therapy" of circulatory disturbances. Moreover, the evaluation of rheologic parameters is extremely useful since epidemiological studies have shown that viscosity may represent a marker and a prognostic factor for the progression of ischemic diseases as well as an independent risk factor, thus suggesting the opportunity of performing controlled clinical studies to evaluate the impact of hemorheological changes in the prevention of cardiovascular events.
血液粘度代表血液的内摩擦力,换言之,是其在切向力作用下发生变形和流动的阻力。此功能受血液的固有特性以及血液流动系统的几何形状制约。因此,任何体外(或离体)血液粘度测量系统都只是对惯性力与粘性阻力之比的相对近似评估。然而,能够以可重复的方式测量血液粘度,为识别一些与流变学参数恶化相关的临床状况提供了契机。于是,分别基于流变学或血液动力学因素的致病作用,定义了“原发性”和“继发性”高粘度综合征。能够进行体外血液粘度测量,为开展多项使用理论上有活性药物的临床药理学研究创造了机会。基于此,出现了针对循环系统紊乱的“流变学疗法”的理论依据。此外,流变学参数的评估极为有用,因为流行病学研究表明,粘度可能是缺血性疾病进展的一个标志物和预后因素,也是一个独立的危险因素,这表明有必要进行对照临床研究,以评估血液流变学变化对预防心血管事件的影响。