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目的探讨急性脑梗塞（ＡＣＩ）患者红细胞流变特性的变化及己酮可可碱（ＰＴＸ）干预治疗的效应。方法采用激光衍射法等方法测定了４６例ＡＣＩ患者的红细胞流变学指标，与２２例正常人对照；并随机将患者分为ＰＴＸ组和低分子右旋糖酐（ＬＭＤ）＋乙酰水杨酸（ＡＳＡ）组对照干预治疗。结果ＡＣＩ患者红细胞流变学指标显著异常，且红细胞变形指数（ＤＩ）与患者神经功能缺损评分（ＮＤＳ）呈显著负相关。用药后两组红细胞流变学指标及ＮＤＳ均有显著改善，随用药时间的延长，ＰＴＸ组改善红细胞变形性（ＥＤ）和减轻患者ＮＤＳ优于ＬＭＤ＋ＡＳＡ联合组。结论红细胞流变特性异常尤其ＥＤ降低是脑梗塞病理生理过程中的重要因素之一，并对患者的病情发展和预后具有重要影响。ＰＴＸ可能是脑梗塞治疗的有效药物之一。
Objective To investigate the changes of erythrocyte rheology and the effects of pentoxifylline (PTX) intervention in patients with acute cerebral infarction (ACI). Methods RBCs were measured in 46 patients with ACI by laser diffractometry and compared with 22 normal controls. Patients were randomly divided into three groups: PTX group, low molecular weight dextran (LMD) + acetylsalicylic acid (ASA) Group control intervention. Results The indexes of erythrocyte rheology in patients with ACI were significantly abnormal, and the erythrocyte deformability index (DI) was significantly and negatively correlated with the neurological deficit score (NDS). After treatment, the indexes of erythrocyte rheology and NDS in both groups were significantly improved. With the prolongation of drug use time, PTX group improved erythrocyte deformability (ED) and alleviated NDS superior to LMD + ASA combination group. Conclusion The abnormal erythrocyte rheology, especially ED, is one of the important factors in the pathophysiology of cerebral infarction and has an important influence on the progression of patients’ condition and prognosis. PTX may be one of the effective drugs for the treatment of cerebral infarction.