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目的 探讨肾综合征出血热 (HFRS)合并急性肾功衰竭 (ARF)患者血液透析 (HD)前后的血液流变性及甲襞微循环的变化规律 .方法 采用瑞典 Gambro公司生产的 AK-10型血液透析机治疗患者 45例 ,血液流变学及甲襞微循环指标分别采用成都仪器厂的 NXE- 1型锥板式粘度计和徐州光学仪器厂的 MX- 75 3B微循环显微镜检测 ,所得数据按田牛氏综合定量评价方法 ,计算综合加权积分值 .结果 HD前后患者血中 BUN,Cr均有明显下降 (P<0 .0 1) ,β2 - MG及血清钾也有下降 (P<0 .0 5 ) ;全血粘度随切变率的增加而降低 ,HCT明显升高 ,红细胞聚集指数 (RAI)、红细胞刚性指数(IR)、血沉 (ESR)、血沉方程 K值 (K)、红细胞电泳时间(EET)均有显著变化 (P<0 .0 1) ,Casson屈服值亦有显著差异 (P<0 .0 5 ) ;甲襞微循环评价指标中 ,微血管形态及微血流流态均有明显好转 ,总积分值变化明显 (P<0 .0 1) .结论 HD治疗前后患者肾功能障碍及电解质紊乱均有明显好转 ,血液流变学及甲襞微循环指标获得显著改善 ,但仍有 6 0 .0 %以上的指标未达到正常标准 .
Objective To investigate the changes of hemorheology and formazan microcirculation before and after hemodialysis (HD) in patients with hemorrhagic fever with renal syndrome (HFRS) complicated with acute renal failure (ARF) .Methods AK-10 type blood Dialysis machine treatment of 45 patients, hemorheology and nailfold microcirculation indicators were used in Chengdu Instrument Factory NXE-1 cone-plate viscometer and the Xuzhou Optical Instrument Factory MX-75 3B microcirculation microscope, the data obtained by the cattle (P <0.01), β2 - MG and serum potassium were also decreased (P <0.05) in the patients before and after HD, . The whole blood viscosity decreased with the increase of shear rate and the HCT increased. The erythrocyte aggregation index (RAI), erythrocyte rigidity index (ESR), erythrocyte sedimentation rate (K), erythrocyte electrophoresis time ) (P <0 01), Casson yield values were also significantly different (P 0 05); micro-circulation index of formazan microcirculation morphology and micro-flow patterns were significantly improved , Total score value changed significantly (P <0.01) .Conclusion HD before treatment Patients with renal dysfunction and electrolyte disturbances were significantly improved, blood rheology and nail microcirculation indicators significantly improved, but there are still more than 6 0.0% of the index does not meet the normal standards.