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目的:探讨慢性阻塞性肺病(COPD)和肺心病急性发作期患者的红细胞变形性变化及其与血气分析、血液流变学的相关性。方法:采用激光衍射法测定(COPD)和肺心病急性发作期的红细胞变形性,同时测定血液流变学和血气分析。结果:肺气肿与肺心病二组在三种切变力下红细胞变形性DI值均无显著差异(P>0.05);肺心病急性加重期PaCO_2,全血高、低切粘度和红细胞压积均高于肺气肿组,两组比较有显著性差异(分别为P<0.01,P<0.05,P<0.01,P<0.01)。红细胞变形性DI值与PaO_2、血pH(7.30～7.38范围)呈正相关关系(均P<0.05);与全血高、低粘度和红细胞压积呈负相关关系(均P<0.05)。结论:慢性肺心病急性加重期红细胞变形性随缺氧和酸中毒的加重而降低,导致全血粘度增加,可能是加重肺心病急性发作期肺动脉高压的原因之一。
Objective: To investigate the changes of erythrocyte deformability in patients with chronic obstructive pulmonary disease (COPD) and acute exacerbation of cor pulmonale, and its correlation with blood gas analysis and hemorheology. Methods: Red blood cell deformability was measured by laser diffractometry (COPD) and acute episode of pulmonary heart disease. Hemorheology and blood gas analysis were also performed. Results: There was no significant difference in erythrocyte deformability (DI) values between the two groups in emphysema and cor pulmonale (P> 0.05). PaCO 2, high whole blood viscosity, low shear viscosity and hematocrit (P <0.01, P <0.05, P <0.01, P <0.01 respectively), which were significantly higher than those in emphysema group. There was a positive correlation between erythrocyte deformability (DI) value and PaO_2 and blood pH (range: 7.30 ~ 7.38) (all P <0.05), negative correlation with high viscosity, low viscosity and hematocrit (all P <0.05). Conclusion: Erythrocyte deformability decreases with the increase of hypoxia and acidosis in acute exacerbation of chronic pulmonary heart disease, which leads to the increase of whole blood viscosity, which may be one of the reasons that aggravate the pulmonary hypertension in acute episode of chronic cor pulmonale.