不同中医证型老年高血压血液流变学可视化的临床观察

目的应用血液流变学可视化检测仪（MC-FAN RH300）观察不同中医证型老年高血压患者血液流动性特点，并检测其与红细胞流变性之间的相关性。方法109例老年高血压患者，按照中医辨证分为痰瘀阻络证组（35例）、阴虚阳亢证组（42例）、肾虚证组（32例）。另选择21名老年健康人作对照（老年健康组）。利用MC-FAN对4组进行血液流变学可视化检测，并观察红细胞变形指数（deformation index，DI）、红细胞聚集指数（erythrocyte aggregation index， EAI）和血浆ATP酶活性，将老年高血压患者血液流变学可视化的血流时间（transiting time，TT）与红细胞流变性指标间进行相关性分析。结果血液流变学可视化TT比较，痰瘀阻络证组较阴虚阳亢证组、肾虚证组、老年健康组显著延长（P<0.05）；在剪切率为100 s－1时的DI比较，痰瘀阻络证组较阴虚阳亢证组、肾虚证组和老年健康组显著降低（P<0.05）。与老年健康组比较，老年高血压患者3组血浆Na+-K+-ATP酶活性、Ca2+-Mg2+-ATP酶活性显著降低（P<0.01）。其中，痰瘀阻络证组Ca2+-Mg2+-ATP酶活性与肾虚证组比较显著降低（P<0.05）。老年高血压患者不同血流量（10、30、60、100 μL）的血液流变学可视化TT与DI呈显著负相关；血流量100 μL时的血液流变学可视化TT与红细胞聚集指数呈显著正相关。结论老年高血压患者的血液流变学可视化TT变化显著，并与传统红细胞流变性指标具有相关性。

英文摘要:

ObjectiveTo observe blood flow features in elderly hypertension patients of different Chinese medical syndrome types and to test their correlation with rheological properties of red blood cells （RBCs） by applying micro-channel array flow analyzer （MC-FAN）. MethodsRecruited were 109 elderly hypertension patients were assigned to phlegm-stasis blocking collateral group （35 cases）， yin deficiency yang hyperactivity group （42 cases）， Shen deficiency group （32 cases） according to Chinese medical syndrome typing. Besides， another 21 elderly healthy subjects were recruited as the control group. The hemorheology visualization testing of elderly hypertension patients was detected using MC-FAN. The erythrocyte deformation index （DI）， erythrocyte aggregation index （EAI）， and erythrocyte related plasma ATPase activity were observed. The correlation between the transiting time （TT） of blood hemorheology visualization and rheological indicators of RBCs were analyzed. ResultsThe hemorheology visualization TT was significantly prolonged more in the phlegm-stasis blocking collateral group than in the yin deficiency yang hyperactivity group， the Shen deficiency group， and the control group （P<0.05）. Compared with the control group， the DI was significantly lower in the phlegm-stasis blocking collateral group than in the yin deficiency yang hyperactivity group， the Shen deficiency group， and the control group （P<0.05） when the shear rate was 100 s－1. Compared with the control group， the plasma Na+-K+-ATPase activity and the plasma Ca2+-Mg2+-ATPase activity were significantly lower in elderly hypertension patients （P<0.01）. Among the three groups， plasma Ca2+-Mg2+-ATPase activity was significantly lower in the phlegm-stasis blocking collateral group than in the Shen deficiency group （P<0.05）. The hemorheology visualization TT （10， 30， 60， and 100 μL） was negatively correlated with DI. The hemorheology visualization TT at 100 μL was positively correlated with EAI. ConclusionChanges of hemorheology visualization TT of elderly hypertension patients were significant and correlated with traditional EAI.

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