Improvement of the Flow Properties of Blood: a New Therapeutical Approach in Occlusive Arterial Disease
Improvement of the Flow Properties of Blood: a New Therapeutical Approach in Occlusive Arterial Disease
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改善血液流动特性：闭塞性动脉疾病的新治疗方法
DOI：
10.1177/000331977602700306
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发表时间：
1976
期刊：
影响因子：
2.8
通讯作者：
A. Ehrly
中科院分区：
文献类型：
--
作者：
A. Ehrly
闭塞性动脉疾病的一般病理生理学基础是微循环中血流速度的降低。通过改善血液的流动特性，可以增加缺血组织中的血流量。血液中纤维蛋白原的浓度和红细胞的变形性是决定血液流动特性的两个主要因素。Ancrod是一种降低纤维蛋白原的物质，通过降低血液和血浆的粘度以及解聚红细胞聚集物来改善血液的流动性。Ancrod对患有严重闭塞性动脉疾病的患者的治疗结果出人意料地好。休息疼痛的消失和止痛药使用量的减少已被统计学证明。在运动肌肉中存在局部高渗透压，这能够降低红细胞的变形能力，从而损害狭窄毛细血管的流动。在体外向血液中添加五氧可可林可通过增加红细胞中的细胞ATP含量来降低高渗透压血液样本中红细胞的硬度。因此，加入己酮可可碱可使高渗血经8微米毛细血管的还原流量增加一倍(p<0.0005)。这些体外结果可能是治疗间歇性跛行患者的新想法的起点。
The general pathophysiological basis in occlusive arterial disease is the reduced flow rate of blood in the microcirculation. Blood flow in the ischemic tissue can be increased by improving the flow properties of blood. The fibrinogen concentration of blood and the deformability of red cells are two main factors determining the flow properties of blood. Ancrod, a fibrinogen-lowering substance, improves the flow properties of blood by decreasing the viscosity of blood and plasma and by desaggregation of erythrocyte aggregates. Treatment of patients suffering from severe occlusive arterial diseases with Ancrod exhibits surprisingly good results. Disappearance of rest pains and reduction in the use of analgetic drugs has been proved statistically. In the exercising muscles a local hyperosmolarity exists, which is able to decrease the deformability of red cells thereby impairing the flow in narrow capillaries. The addition of Pentoxifyllin to blood in-vitro reduces the rigidity of red cells in hyperosmolar blood samples by increasing their cellular ATP-content. Thus the reduced flow rate of hyperosmolar blood through 8 mu-capillaries could be increased twice (p less than 0.0005) by the addition of Pentoxifyllin. These in-vitro results could be the starting point of a new idea for the treatment of patients with intermittent claudication.