Importancia de la medición de la Viscosidad sanguínea: retos y limitaciones

La sangre es una mezcla de componentes que tiene su propia identidad. Una de las propiedades físicas que adquiere es su viscosidad, la cual es la resistencia que ofrece para desplazarse. A diferencia de sus componentes (como glucosa, hemoglobina, colesterol, etc.), la sangre no posee un nivel único de viscosidad, sino que esta es variable debido a diversos factores. Exponemos algunos principios físicos que nos permitirán entender mejor esta dinámica de la viscosidad sanguínea, y su posible aplicación en algunos fenómenos hemodinámicos, así como la complejidad de su medición en la práctica clínica habitual.

Blood is a mixture of components that has its own identity. One of the physical properties that it acquires is its viscosity, which is the resistance it offers to move. Unlike its components (such as glucose, hemoglobin, cholesterol, etc.), blood does not have a single level of viscosity, but it is variable due to various factors. We present some physical principles that will allow us to better understand these dynamics of blood viscosity, and its possible application in some hemodynamic phenomena, as well as the complexity of its measurement in routine clinical practice.

The enlightenment of hemodynamic principleson for prevention and treatment of allograft rejection / 中华器官移植杂志

Antibody mediated rejection (AMR) starts from the binding of donor specific antibody (DSA) to its target antigen on endothelium. Whether or not a circulating DSA would bind to its static target depends on the relative strength between the antigen-antibody attraction potential energy and the kinetic energy of a circulating DSA. The attraction potential energy between antigen & antibody mainly depends on affinity of antibody to its target and is relatively constant. The kinetic energy of antibody depends on its velocity. The faster it moves the higher kinetic energy it possesses (E=mV 2/2). Therefore, the primary endothelial injury has always occurred in capillary which has the lowest blood flow rate. Even though DSA moves at the lowest velocity in capillary (≤1 mm/s), compared to its size (diameter<10 nm), the relative velocity of DSA is very high, which moves a distance of 100, 000 diameter of antibody per second. It is nearly 20, 000 times over the highest relative velocity of Bolt, the world record holder in 100 meters. Therefore, it is not easy for a fast-moving DSA to bind to its static target since the attraction potential energy between antigen and antibody needs to overcome the great kinetic energy of DSA. These basic concepts of hemodynamics and the relative velocity of DSA gives us at least the following inspirations: (1)It is easier for a DSA to bind its antigen in vitro, since there is no relative motion between antigen and antibody in test tube; while it is more difficult for a fast-moving DSA to bind to its static antigen in vivo, since the attraction potential energy between antigen & antibody needs to overcome the great kinetic energy of a fast-moving DSA.(2)A cytotoxic agent usually kills its peripheral blood target with a much higher depletion efficacy than for its target in tissue, since it runs with its circulating target without relative motion, while it is more difficult for a fast-moving agent with a great kinetic energy to bind its static target in tissue.(3)Some patients remain positive for DSA for a long time without the evidence of AMR. This is possibly due to a lower attraction potential energy between antigen-antibody, or due to a higher kinetic energy of a fast-moving DSA in the circumstance without microvascular occlusion.(4)Endothelial injury, resulting from ischemia and reperfusion or others, usually cause microvascular thrombosis, which results in partial or complete occlusion of microvascular system and favors antigen-antibody interaction.(5)Based on the fact that blood flow rate can affect antibody-antigen binding, we can reasonably infer that maintaining a good microcirculation in allograft will help to prevent or treat AMR. The strategies may include prevention of leukocyte adhesion, platelet deposition, red blood cell aggregation, and reduction of blood lipid and viscosity, to have plenty of water, and to do regular exercise. These strategies are equally important for prevention or treatment of cell mediated rejection.

Efficacy of Naoxintong capsule combined with butylphthalide injection on acute cerebral infarction and its effects on inflammatory factors, oxidative stress response and hemorheology / 中国基层医药

Objective:To investigate the effect of Naoxintong capsule combined with butylphthalide injection on inflammatory factors, oxidative stress response and hemorheology in patients with acute cerebral infarction. Methods:Eighty-six patients with acute cerebral infarction who received treatment in Zhuji Hospital of Traditional Chinese Medicine from December 2017 to December 2019 were included in this study. Thrombolysis and thrombectomy were contraindicated in these patients. They were randomly assigned to receive treatment either with butylphthalide injection (control group, n = 43) or butylphthalide injection and Naoxintong capsule (observation group, n = 43) for 2 weeks. Therapeutic effects, Barthel Index, inflammatory factors (C-reactive protein, intercellular adhesion molecule-1 and interleukin-6), oxidative stress response (malondialdehyde and superoxide dismutase) and hemorheology (whole blood viscosity at high and low shear rates, plasma viscosity and fibrinogen) were compared between the two groups. Results:Total effective rate in the observation group was significantly higher than that in the control group (93.02% vs. 72.09%, χ2 = 6.541, P < 0.05). After treatment, Barthel Index in the observation group was significantly higher than that in the control group [(61.51 ± 5.24) points vs. (50.43 ± 4.81) points, t = 10.215, P < 0.05). After treatment, serum levels of C-reactive protein, intercellular adhesion molecule-1, and interleukin-6 in the observation group were (4.42 ± 1.03) mg/L, (84.23 ± 5.05) μg/L and (94.33 ± 10.22) μg/L, respectively, which were significantly lower than those in the control group [(8.32 ± 1.71) mg/L, (103.51 ± 6.35) μg/L, (118.92 ± 13.31) μg/L, t = 12.810, 15.583, 9.609, all P < 0.05]. After treatment, serum malondialdehyde level in the observation group was significantly lower than that in the control group [(3.76 ± 0.78) μmol/L vs. (4.94 ± 0.90) μmol/L, t = 6.497, P < 0.05]. Serum superoxide dismutase level in the observation group was significantly higher than that in the control group [(35.76 ± 2.65) U/L vs. (30.34 ± 2.11) U/L, t = 10.492, P < 0.05]. After treatment, whole blood viscosity at high and low shear rates, plasma viscosity and fibrinogen levels in the observation group were (4.10 ± 0.51) mPa · s, (9.31 ± 1.36) mPa · s, (1.24 ± 0.26) mPa · s and (2.71 ± 0.40) g/L respectively, which were significantly lower than those in the control group [(5.72 ± 0.76) mPa · s, (11.49 ± 1.59) mPa · s, (2.21 ± 0.32) mPa · s and (3.92 ± 0.54) g/L, t = 11.607, 6.832, 15.427 11.807, all P < 0.05). Conclusion:Naoxintong capsule combined with butylphthalide injection is highly effective in the treatment of acute cerebral infarction. It can reduce inflammatory reaction and improve oxidative stress response and hemorheological changes.

Síndrome de hiperviscosidade em paciente com mieloma múltiplo / Hyperviscosity syndrome in multiple myeloma patients

O mieloma múltiplo é uma neoplasia progressiva e incurável de células B, caracterizado pela proliferação desregulada e clonal de plasmócitos na medula óssea. A síndrome de hiperviscosidade é uma das complicações relacionadas às gamopatias monoclonais, sendo considerada emergência oncológica. O objetivo deste estudo foi descrever o quadro clínico de um paciente diagnosticado com mieloma múltiplo que apresentou síndrome de hiperviscosidade, avaliando a prevalência de sinais e sintomas, bem como características fisiopatológicas dessa entidade clínica. Foi revisado o prontuário de um paciente internado na enfermaria da Clínica Médica do Hospital Regional do Cariri (CE) no período de junho a julho de 2018. Além disso, foi realizada revisão de literatura em base de dados (PubMed®) direcionada ao tema proposto. O diagnóstico de mieloma múltiplo foi comprovado por mielograma, sendo prontamente iniciada a corticoterapia e avaliada a resposta clínica após essa terapêutica. Apesar de incomum e menos frequentemente relacionada ao mieloma múltiplo, a síndrome de hiperviscosidade está relacionada a uma grande taxa de mortalidade quando apresenta diagnóstico tardio. A terapia de primeira linha indicada para a síndrome de hiperviscosidade foi a plasmaferese, no entanto, as condições clínicas (instabilidade hemodinâmica) impossibilitaram sua realização. O desfecho deste caso foi o óbito do paciente. Concluiu-se que o diagnóstico precoce e a intervenção terapêutica estão diretamente relacionados à ocorrência de menor incidência de complicações relacionadas ao mieloma múltiplo e à síndrome de hiperviscosidade.

Multiple myeloma is a progressive and incurable B-cell neoplasm characterized by unregulated and clonal proliferation of plasmocytes in the bone marrow. Hyperviscosity syndrome is one of the complications related to monoclonal gammopathies and is considered an oncological emergency. The aim of this study was to describe the clinical condition of a patient diagnosed with multiple myeloma who presented hyperviscosity syndrome, evaluating the prevalence of symptoms and signs, as well as the pathophysiological characteristics of this clinical entity. The medical records of a patient admitted to the Internal Medicine ward of the Hospital Regional do Cariri (CE) from June to July of 2018 were reviewed. In addition, we conducted a literature review in a database (PubMed®) directed to the theme proposed. The diagnosis of multiple myeloma was confirmed by myelogram, and corticosteroid therapy was promptly initiated and the clinical response was evaluated after this therapy. Although uncommon and less frequently related to multiple myeoloma, hyperviscosity syndrome is related to a high mortality rate when diagnosed late. The first line therapy indicated to hyperviscosity syndrome was plasmapheresis; however, the clinical conditions (hemodynamic instability) precluded its performance. The outcome of this case was the patient's death. Thus, it was concluded that early diagnosis and therapeutic intervention are directly related to the occurrence of lower incidence of complications related to multiple myeloma and hyperviscosity syndrome.

Blood Viscosity As A Determining Factor Of Ischemic Stroke Outcomes Evaluated With Nihss And Mrs On Day 7 And 30 Post-Thrombolysis

Objective: This study aimed to analyze blood viscosity as a determining factor of ischemic stroke outcomes evaluated with National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) on day 7 and 30 post-thrombolysis. Methods: This study was a 4-months cohort study taking place in Cipto Mangunkusumo General Hospital from January to April 2017. Subjects were collected at the Emergency Department or Neurology Outpatient Department. Eligible patients gave informed consent. Patients underwent numerous examinations, including blood viscosity test using digital microcapillary (DM) instrument. Outcomes of patients were identified on day 7 and day 30 post-thrombolysis using NIHSS and mRS, respectively. Results: Most acute ischemic stroke patients (88.6%) had blood hyperviscosity. 9.1% patients had poorer neurologic deficit on day 7 evaluated with NIHSS and 18.2% patients had poor outcome on day 30 evaluated with mRS. All patients with normal blood viscosity did not have a poorer neurologic deficit on day-7-evaluation. Conclusion: Blood viscosity determines the outcomes of acute ischemic stroke patients on day 7 and day 30 post-thrombolysis.

Amlodipine alters hemorheological parameters: Increased efficacy at the cost of edema?

Background Despite several decades of use of calcium channel blockers, the side effect of edema persists as a class effect, and its mechanism is unresolved. Amlodipine has effects on hemorheology (HR), and its hemodilutory property may partly contribute to its antihypertensive action. This aspect is not well studied, and the literature is sparse in this regard. Objective This experiment was planned to determine effect of a single-dose administration of amlodipine on HR parameters in normal human volunteers. Methods and results Amlodipine (5 mg) or S (-) amlodipine (2.5 mg) was administered to 27 normal human volunteers. Whole-blood viscosity (WBV) at different shear rates, plasma viscosity (PV), red cell rigidity (RCR), red cell aggregation (RCA), hematocrit (Hct), plasma hemoglobin, along with plasma drug concentration were determined at time intervals, t = 0, 4, 8, 12, and 24 h. Statistically significant reductions were observed at tmax = 4 h in WBV at shear rates of 0.512 s–1 (p < 0.005), WBV at shear rates of 5.26 s–1 (p < 0.01), PV (p < 0.05), and Hct (p < 0.01). At t = 8 h, as drug concentration reduced, some of the changes persisted and later slowly decreased with the decreasing drug concentration till t = 24 h. Red blood cell–related parameters such as RCA and RCR remained unaltered. WBV values at all shear rates, when corrected for Hct = 0.45, did not show deviation from their original values at any time. Conclusions Amlodipine causes a reduction in Hct and blood viscosity, along with hemodilution. These effects persist as long as the drug remains in plasma. Edema resulting from chronic dosing may be explained by the aforementioned effects. It is possible that antihypertensive action of the drug may be due to a combination of vasodilatation and an improvement in the HR properties.

Whole-Body Vibration Training Increases Myocardial Salvage Against Acute Ischemia in Adult Male Rats / Treinamento de Vibração de Corpo Inteiro Aumenta o Resgate Miocárdico contra Isquemia Aguda em Ratos Machos Adultos

Abstract Background: Whole body vibration training (WBV) is a new training program, which is safe and effective. It can be followed by the public. However, data on the safety and efficacy of vibration on myocardial ischemia reperfusion (IR) injury are lacking. Objective: To examine the effect of WBV on the tolerance of the myocardium to acute IR injury in an experimental rat model. Methods: Twenty-four male Wistar rats were divided into control and vibration groups. Vibration training consisted of vertical sinusoidal whole body vibration for 30 min per day, 6 days per week, for 1 or 3 weeks (WBV1 and WBV3 groups, respectively). All the rats were submitted to myocardial IR injury. Myocardial infarct size and ischemia-induced arrhythmias were assessed. Differences between variables were considered significant when p < 0.05. Results: No differences were observed between the groups regarding the baseline hemodynamic parameters. Infarct size was smaller in the experimental group (control, 47 ± 2%; WBV1, 39 ± 2%; WBV3, 37 ± 2%; p < 0.05, vs. control). Vibration produced a significant decrease in the number and duration of ventricular tachycardia (VT) episodes compared to the control value. All ventricular fibrillation (VF) episodes in the vibration groups were self-limited, while 33% of the rats in the control group died due to irreversible VF (p = 0.02). Conclusion: The data showed that vibration training significantly increased cardiac tolerance to IR injury in rats, as evidenced by reduction in the infarct size and cardiac arrhythmias, and by facilitating spontaneous defibrillation.

Resumo Fundamento: O treinamento com vibração de corpo inteiro (WBV) é um novo programa de treinamento seguro e eficaz, e pode ser seguido pelo público. No entanto, dados sobre a segurança e eficácia da vibração na lesão de isquemia e reperfusão (IR) do miocárdio estão em falta. Objetivo: Examinar o efeito da WBV na tolerância do miocárdio à lesão aguda por IR em um modelo experimental em ratos. Métodos: Vinte e quatro ratos Wistar machos foram divididos em 2 grupos: controle e vibração. O treino de vibração consistiu em vibração sinusoidal vertical de corpo inteiro durante 30 min por dia, 6 dias por semana, durante 1 ou 3 semanas (grupos WBV1 e WBV3, respectivamente). Todos os ratos foram submetidos a lesão por IR do miocárdio. O tamanho do infarto do miocárdio e as arritmias induzidas por isquemia foram avaliados. As diferenças entre as variáveis foram consideradas significativas quando p < 0,05. Resultados: Não foram observadas diferenças entre os grupos em relação aos parâmetros hemodinâmicos basais. O tamanho do infarto foi menor no grupo experimental (controle, 47 ± 2%; WBV1, 39 ± 2%; WBV3, 37 ± 2%; p < 0,05, vs. controle). A vibração produziu uma diminuição significativa no número e duração das taquicardia ventriculares (TV) em comparação com o valor de controle. Todos os episódios de fibrilação ventricular (FV) nos grupos de vibração foram autolimitados, enquanto 33% dos ratos do grupo controle morreram devido a FV irreversível (p = 0,02). Conclusão: Os dados mostraram que o treinamento com vibração de corpo inteiro aumentou significativamente a tolerância cardíaca à lesão de IR em ratos, como evidenciado pela redução do tamanho do infarto e arritmias cardíacas, e pela facilitação da desfibrilação espontânea.

Correlation of hemoglobin A1c with blood viscosity and peripheral arterial blood flow in patients with type 2 diabetes mellitus / 上海交通大学学报（医学版）

Objective • To investigate the relationship of hemoglobin A1c (HbA1c) with blood viscosity and peripheral arterial blood flow in patients with type 2 diabetes mellitus (T2DM). Methods • A total of 345 patients with T2DM were divided into four groups according to the HbA1c levels: group A (HbA1c<7.0%, 79 cases), group B (7.0% ≤ HbA1c<8.5%, 94 cases), group C (8.5% ≤ HbA1c<10.0%, 95 cases) and group D (HbA1c ≥ 10.0%, 77 cases). All patients were tested for blood glucose, HbA1c, blood viscosity and peripheral arterial ultrasound. Spearman and Pearson correlation as well as stepwise multivariate regression analyses were performed to analyze the data. Results • The whole blood viscosities at 1/s, 5/s, 30/s and 200/s shear rates of group B, C and D (HbA1c ≥ 7%) were significantly higher than those of group A (HbA1c<7.0%). The high shear reduction viscosities of group C and D (HbA1c ≥ 8.5%) were significantly higher than those of group A and B (HbA1c<8.5%). Spearman correlation analysis demonstrated that HbA1c was positively correlated with whole blood viscosities at 5/s, 30/s and 200/s shear rates and high shear reduction viscosity (HSRV) (P<0.05). In stepwise multivariate regression analysis, HbA1c had positive correlations with the whole blood viscosities at 5/s, 30/s and 200/s shear rates and HSRV after being adjusted for other factors (P<0.05). HbA1c showed significantly negative correlations with the left and right internal carotid arterial inner diameters after being corrected for relevant factors (P<0.05). Conclusion • The blood HbA1c levels in T2DM patients are positively correlated with blood viscosity, and HSRV, and negatively correlated with left and right internal carotid arterial inner diameters, but have no significant correlation with peripheral arterial blood flow velocity.

Effect of Blood Donation on the Donor's Hemorheological Properties / 대한수혈학회지

The circulatory system is closely related to the inter-relationship between the anatomy of the heart and blood vessels, and the fluid dynamic properties of blood. The physical properties of blood, which affect blood flow, are called hemorheologic factors. Hemorheologic factors, such as blood viscosity and erythrocyte aggregation, are influenced mainly by hematocrit. A higher hematocrit level results in an increase in blood viscosity, erythrocyte aggregation, which impedes the circulation itself, and tissue oxygenation. An excess of serum ferritin causes injury to vascular endothelial cells and erythrocytes via oxygen free radicals. In addition, an excess of blood can aggravatee the adverse effects of the hemorheologic parameters and induce atherogenesis, microcirculatory disturbances, and major cardiovascular events. A preventive and therapeutic approach with a phlebotomy or blood donation has been stimulated by the knowledge that blood loss, such as regular donations, is associated with significant decreases in key hemorheologic variables, including blood viscosity, erythrocyte aggregation, hematocrit, and fibrinogen. Major cardiovascular events have been improved in regular blood donors by improving blood flow and microcirculation by decreasing the level of oxidative stress, improving the hemorheologic parameters, and reducing the serum ferritin level. Confirmation of the positive preventive and therapeutic effects of blood donations on cardiovascular disease by a well-designed and well-controlled Cohort study may be good news to patients with cardiovascular disease or at risk of these diseases, as well as patients who require a transfusion.

Does Blood Flow Change according to Mood? Blood Rheology in Bipolar Disorder

OBJECTIVE: Bipolar disorder (BD) is associated with increased rates of cardiovascular diseases. There is growing evidence that blood viscosity may have a common role, correlated with well-known major risk factors that promote cardiovascular disease. In this study we aimed to investigate the whole blood viscosity (WBV) in different stages of BD. METHODS: A total of 121 bipolar patients and 41 age-gender matched healthy controls were included. Forty-four of bipolar patients were in manic, 35 were depressed and 42 were in euthymic state. WBV was calculated from hematocrit and total plasma protein according to Simone’s formula at low and high shear rates (LSR and HSR). RESULTS: WBV at HSR of manic group was 16.91±1.01, depressive group was 17.23±0.80, euthymic group was 17.63±0.95, and control group was 17.52±0.71 (p=0.001). WBV at LSR of manic depressive, euthymic and control group were 53.10±20.58, 60.30±17.02, 68.91±20.33, and 62.01±19.28, respectively (p=0.001). Both WBV at HSR and LSR of manic group was significantly lower than that of the euthymic and control groups (p=0.001 and 0.010 respectively for HSR, p=0.001 and 0.011 respectively for LSR). WBV was significantly positively correlated with lipid profile except high density lipoprotein (HDL). CONCLUSION: Our results demonstrate a decrement in blood viscosity in manic episode compared with euthymics and controls. Positive correlation of blood viscosity with lipid parameters (except HDL), and negative correlation with number of previous manic episodes suggest that manic episode has favorable effect on cardiovascular risk regarding to blood viscosity.

Study on spectrum-effect relationship among effects of different extracts of Crataegi Folium on whole blood viscosity in rats / 中草药

Objective: To study the correlation between the fingerprints of different extracts of Crataegi Folium and reducing the blood viscosity of blood stasis rats, and to provide a theoretical basis and data support for the establishment of the quality control model of traditional Chinese medicine, which is "Fingerprints are associated with efficacy". Methods: Fingerprints of different extracts of Crataegi Folium were established by high performance liquid phase method. The multivariate linear regression equation of common peak X and whole blood viscosity Y was calculated by stepwise regression analysis of MATLAB software. Results: There were 32 common peaks in the fingerprints, X9, X10, X11, X13, X14, X15, X17, X19, X27, and X29 related to the whole blood viscosity Y compose functional composition groups. X10, X11, X13, X19, X29 negatively correlated with Y, which may be active monomer components, among which X14 is vitexin glucoside, X17 is Vitexin, and X19 is rutin. Conclusion: The multiple regression equation calculated by MATLAB statistical software in this study has significance in statistics, which can provide a scientific basis for further study of the active components of Crataegi Folium extract.

Clinical Study on Electronic Moxibustion in Treating Diabetic Peripheral Neuropathy / 上海针灸杂志

Objective To observe the clinical efficacy of electronic moxibustion in treating diabetic peripheral neuropathy due to liver-kidney deficiency. Method Ninety patients with diabetic peripheral neuropathy due to liver-kidney deficiency were randomized into a treatment group of 44 cases and a control group of 46 cases. The treatment group was intervened by acupoint therapy by warm electronic moxibustion, while the control group was intervened by foot bath with Chinese medication. For both groups, 10 treatment sessions were taken as a course of treatment, for 3 courses in total. Before and after the treatment, the whole blood viscosity, blood lipids, fasting blood glucose (FBG), glycosylated hemoglobin (GHb) and Michigan Neuropathy Screening Instrument (MNSI) were evaluated in the two groups. Result The whole blood viscosity indexes, blood lipids levels, FBG level and GHb level didn't show significant differences after the treatment in the two groups (P>0.05). The intra-group and inter-group comparisons of MNSI score showed significant differences after the treatment (P<0.01); there was a between-group difference in the change of MNSI score after the treatment (P<0.01). Conclusion Electronic moxibustion is an effective approach in treating diabetic peripheral neuropathy.

Analysis of changes of hemorheological indexes in patients with intracranial infection after traumatic brain injury / 国际检验医学杂志

Objective To investigate the changes of hemorheological indexes in patients with intracranial infection after traumatic brain injury.Methods 87 cases with intracranial infection after brain trauma ,admit-ted in South Hospital of the Sixth People's Hospital Affiliated to Shanghai JiaoTong University ,from October 2016 to October 2017 ,were selected as the intracranial infection group ,and 80 cases without intracranial infec-tion after brain trauma ,admitted in the hospital from June 2015 to December 2016 ,were selected as the unin-fected group.hemorheological indexes and Glasgon Coma Scale (GCS) score were compared between the two groups.Results The high shear viscosity ,low shear viscosity ,plasma viscosity and fibrinogen(Fib) content in the intracranial infection group were higher than those in the uninfected group ,and the differences were statis-tically significant (P＜0.05) ;the GCS score of the intracranial infection group was lower than that of the un-infected group ,and the differences were statistically significant (P＜0.05) ;the high shear viscosity ,low shear viscosity ,plasma viscosity and Fib content in severe infection group were higher than those in moderate infec-tion group and mild infection group ,and the high shear viscosity ,low shear viscosity ,plasma viscosity and Fib content in moderate infection group were higher than those in mild infection group ,and the differences were statistically significant (P＜0.05) ;the GCS score of severe infection group was lower than those of moderate infection group and mild infection group ,the GCS score of moderate infection group was lower than that of mild infection group ,and the differences were statistically significant (P＜0.05).Conclusion Abnormal hem- orrheology is present in patients with intracranial infection after traumatic brain injury ,and its change is close-ly related to the severity of the disease.

Analytical Performance and Reference Interval of a Microfluidic Viscometer, Viscore-300 for the Measurement of Whole Blood Viscosity

BACKGROUND: Whole blood viscosity (WBV) refers to the internal resistance that occurs when blood flows through blood vessels. WBV is known to be related to many diseases including cardiovascular and neurovascular diseases. We have investigated the analytical performance and established reference intervals for a newly developed microfluidic viscometer, Viscore-300 (NanoBiz, Korea), used for the measurement of WBV. METHODS: We performed a precision test of 240 measurements over 20 days using three control materials. For evaluation of repeatability, a total of 60 WBV measurements were made in 3 whole blood samples 20 times a day. A total of 100 whole blood samples were used to evaluate the accuracy of the Viscore-300 in comparison to a rotating viscometer, DV3T (Brookfield, USA), in accordance with the the Clinical and Laboratory Standards Institute's guidelines. To establish the reference intervals, 122 healthy individuals were enrolled in this study. RESULTS: The precision and repeatability results showed that the CV was less than 5% for three samples and two shear rates. In the accuracy test, the mean differences between two viscometers were 0.09 cP (0.9%) and −0.07 cP (−1.4%) at shear rates of 10 s−1 and 300 s−1, respectively. The reference intervals of WBV for men were 6.88–13.52 cP at 10 s−1 and 4.32–6.43 cP at 300 s−1; those of women were 5.74–13.29 cP at 10 s−1 and 3.60–6.12 cP at 300 s−1. CONCLUSIONS: Viscore-300 showed excellent precision and accuracy and it might be a good instrument for reporting WBV quickly and accurately.

Clinical observation on Danshen Chuangxiongqin Injection in treatment of posterior circulation ischemia vertigo / 药物评价研究

Objective To observe the clinical effect of Danshen Chuangxiongqin Injection in treatment of posterior circulation ischemia vertigo.Methods Patients (80 cases) with posterior circulation ischemia vertigo attack in Anhui Hospital of Traditional Chinese from March 2015 to March 2017 were randomly divided into control and treatment groups,and each group had 40 cases.Patients in control group were treated by Betahistine mesylate,6 mg/time (3 times/d) for 2 weeks.Patients in treatment group were iv administered with Danshen Chuangxiongqin Injection (10 mL/d) added into normal saline 250 mL,once daily for 2 weeks.After treatment,the efficacy was evaluated,and the levels of blood viscosity index,fibrinogen in two groups before and after treatment were compared.Results Total effective rate of observation group was 92.5％ which was higher than the control group's 72.5％ with significant difference (P ＜ 0.05).After treatment,the laboratory indexes (levels of blood viscosity,fibrinogen,and so on) were decreased,the improvement degree of these indexes in treatment group were significantly better than those in control group,with significant difference between two groups (P ＜ 0.05).Conclusion Danshen Chuangxiongqin Injection has significant effect in treating posterior circulation ischemia vertigo and it is worthy of clinical application and promotion.

Effect of Yiqi Huoxue Huatan Formula combined with low-dose atorvastatin on arterial stiffness, blood viscosity and prognosis in patients with high-risk COPD / 重庆医学

Objective To investigate the effect of Yiqi Huoxue Huatan Formula combined with low-dose atorvastatin on arterial stiffness,blood viscosity and prognosis in the patients with high-risk chronic obstructive pulmonary disease (COPD).Methods A total of 240 patients with high-risk COPD and risk factors of cardiovascular disease were divided into the statin group(A),Yiqi H uoxue H uatan group(B),combined group(C) and control group(D),60 cases in each group.All groups were treated with routine therapy.On this basis,the group A was combined with low-dose atorvastatin,the group B was combined with Yiqi Huoxue Huatan Formula.On the basis of the group A,the group C was combined with Yiqi Huoxue Huatan Formula.All groups were treated for 6 months.The changes of TCM syndrome scores,arterial stiffness index and blood rheological indexes in 4 groups were observed and compared between before and after treatment.The situation of adverse reactions occurrence and prognosis were recorded.Results After 6 months of treatment,the TCM syndrome scores and carotid artery-femoral artery pulse wave velocity (PWV)in 4 groups were significantly decreased compared with those before treatment,which in the group C,A,B and D was gradually increased (P＜ 0.05).After 6 months of treatment,there was no significant change of whole blood viscosity and hematocrit in the group D (P＞ 0.05),which in the other 3 groups were significantly decreased compared with those before treatment,moreover the group C was significantlylower than the group A and B (P＜0.05),while there was no statistically significant difference between the group A and B (P＞0.05).The incidence rate of adverse reactions had no statistically significant difference among the four groups (P＞ 0.05).The BODE index showed gradual increase ih the group C,A,B and D (P＜0.05).Conclusion Yiqi Huoxue Huatan Formula combined with low-dose atorvastatin has an positive effect in regulating the blood rheological state and promoting the prognostic recovery in the patients with high-risk COPD and risk factors of cardiovascular disease.

Effect of Yiqi Huoxue Huatan Formula combined with low-dose atorvastatin on arterial stiffness, blood viscosity and prognosis in patients with high-risk COPD / 重庆医学

Objective To investigate the effect of Yiqi Huoxue Huatan Formula combined with low-dose atorvastatin on arterial stiffness,blood viscosity and prognosis in the patients with high-risk chronic obstructive pulmonary disease (COPD).Methods A total of 240 patients with high-risk COPD and risk factors of cardiovascular disease were divided into the statin group(A),Yiqi H uoxue H uatan group(B),combined group(C) and control group(D),60 cases in each group.All groups were treated with routine therapy.On this basis,the group A was combined with low-dose atorvastatin,the group B was combined with Yiqi Huoxue Huatan Formula.On the basis of the group A,the group C was combined with Yiqi Huoxue Huatan Formula.All groups were treated for 6 months.The changes of TCM syndrome scores,arterial stiffness index and blood rheological indexes in 4 groups were observed and compared between before and after treatment.The situation of adverse reactions occurrence and prognosis were recorded.Results After 6 months of treatment,the TCM syndrome scores and carotid artery-femoral artery pulse wave velocity (PWV)in 4 groups were significantly decreased compared with those before treatment,which in the group C,A,B and D was gradually increased (P＜ 0.05).After 6 months of treatment,there was no significant change of whole blood viscosity and hematocrit in the group D (P＞ 0.05),which in the other 3 groups were significantly decreased compared with those before treatment,moreover the group C was significantlylower than the group A and B (P＜0.05),while there was no statistically significant difference between the group A and B (P＞0.05).The incidence rate of adverse reactions had no statistically significant difference among the four groups (P＞ 0.05).The BODE index showed gradual increase ih the group C,A,B and D (P＜0.05).Conclusion Yiqi Huoxue Huatan Formula combined with low-dose atorvastatin has an positive effect in regulating the blood rheological state and promoting the prognostic recovery in the patients with high-risk COPD and risk factors of cardiovascular disease.

Clinical efficacy of milrinone injection in the treatment of pulmonary heart disease complicated with respiratory failure / 中国生化药物杂志

Objective To investigate the clinical effect of milrinone injection combined therapy in patients with cor pulmonale complicated with respiratory failure and observe the effect of milrinone on blood gas index, blood viscosity and pulmonary arterial pressure.Methods The clinical data of 100 patients with cor pulmonale complicated with respiratory failure were retrospectively analyzed from April 2014 to April 2016.Among them, 50 cases were treated with conventional oxygen therapy, diuretic, asthma and anti-infection treatment.In the control group, 50 cases were treated with milrinone injection as the treatment group.The clinical curative effect and adverse reaction were analyzed.The blood gas analysis index, blood viscosity and pulmonary arterial pressure were measured before and after the treatment.The sputum normal and cyanosis, cough, wet rales and edema time were recorded in the two groups.Results The total effective rate of the treatment group was 92.0%, which was significantly higher than that of the control group 70.0%(P <0.05).After treatment, the hemorheological indexes and blood gas analysis indexes of the two groups improved significantly, However, the improvement of the indicators of the treatment group were significantly better than the control group (P<0.05).The pulmonary arterial pressure in the treatment group was (18.36 ±7.38) mmHg, which was significantly lower than that in the control group (23.79 ±6.14) mmHg (P<0.05); After treatment, the sputum normal and cyanosis in the treatment group, cough, wet rales, edema time were significantly shorter than the control group ( P <0.05 ) .No significant adverse effects were observed in both groups during the treatment.Conclusion The use of milrinone injection comprehensive treatment of pulmonary heart disease with respiratory failure in patients with significant efficacy and safety , but also can help improve blood viscosity and blood gas analysis indicators, reduce pulmonary artery pressure, better promote the rehabilitation of patients.

Diabetes pill in combination with metformin on elderly patients with type 2 diabetes mellitus with cerebral microvascular lesion blood viscosity, the effects of cognitive dysfunction / 中国生化药物杂志

Objective To summarize analysis in elderly patients with type 2 diabetes mellitus with cerebral microvascular lesion with diabetes pill in combination with metformin on patients after treatment the blood viscosity, the effects of cognitive dysfunction.Methods Our hospital during the period of July 2014 to September 2016 received 100 cases of elderly patients with type 2 diabetes mellitus with cerebral microvascular lesions, according to the random allocation method divided into observation group(50 cases) and control group(50 cases) and control group using metformin treatment, the observation group USES the diabetes pill metformin treatment, treatment effect of two groups of patients and related indicators for comparative analysis.Results After treatment the cognitive function score and blood viscosity related indicators, statistically significant differences between observation group and control group.Conclusion Elderly patients with type 2 diabetes mellitus with cerebral microvascular lesions in clinical application in diabetes, pill metformin, help to improve the patient's cognitive dysfunction, improve the patient's blood viscosity, promote the prognosis of patients, is worthy of popularization and application.

Effects of Panax Notoginseng Saponins Enteric-coated Pellets on Hemorheology in Rabbits / 中国药师

Objective:To discuss the effects of panax notoginseng saponins (PNS) enteric-coated pellets on hemorrheology in rabbits.Methods:The rabbits were divided into the normal control group,the model control group,Xueshuangtong injection (lyophilization) group(15 mg·kg-1·d-1 ,im),PNS enteric-coated pellets groups respectively at high(45 mg·kg-1·d-1,ig),medium(30 mg·kg-1·d-1,ig) and low (15 mg·kg-1·d-1,ig) dose.The model was established by intragastric administration of high-fat diet.The whole-blood viscosity,plasma viscosity,erythrocyte aggregational index,crythrocyte index of rigidity and erythrocyte electro-phoresis rate in the groups were detected using hemorheological methods.Results:The above indices of hemorheology in the model control group were all significantly higher than those in the normal control group (P0.05).Compared with Xueshuangtong injection (lyophilization) group,PNS enteric-coated pellets group at medium dose could significantly reduce the whole blood middle shear viscosity(P<0.05).Conclusion:PNS enteric-coated pellets can reduce the whole-blood viscosity,plasma viscosity,erythrocyte aggregational index,crythrocyte index of rigidity and erythrocyte electro-phoresis rate,and effectively promote blood circulation and remove stasis,inhibit thrombosis formation and increase blood supply for heart and cerebral vessels.