Hyperviscosity in the elderly
Introduction
Introduction Hyperviscosity (or hyperviscosity) is a clinical pathological syndrome characterized by an increase in blood rheology parameters due to elevated blood viscosity factors, blood transition, and slow blood flow. . The elasticity of the blood vessel wall of the elderly is gradually weakened, and the lumen is gradually narrowed, so that the cells are easily close to each other, causing an increase in blood viscosity, thereby slowing the blood flow rate and causing cardiovascular disease. At the same time, the increase in blood viscosity in the elderly is associated with increased levels of proteins (globulin, fibrin) and lipids (triglycerides, cholesterol) in plasma.
Cause
Cause
1 cell concentration is too high: the number of cells in the blood is relatively increased. For example, if the water in the elderly is relatively reduced and the water content in the blood is also reduced, the proportion of blood cells will increase relatively. As the liquid component in the blood decreases, the solid content increases, and the viscosity in the blood naturally increases.
2 blood viscosity increased: in addition to red blood cells in the blood, there are many plasma proteins, such as globulin, fibrinogen and so on. When these macromolecular proteins are increased, they often bind to red blood cells into a mesh, which increases the resistance of blood flow and leads to an increase in blood viscosity.
3 The accumulation of blood cells is increased: the cells in the blood should be a single executive function, rather than accumulating together. When there is some abnormality in the structure of red blood cells or platelets, red blood cells and platelets will accumulate together, which will block blood vessels and form a blood clot.
4 The deformability of blood cells is weakened: the capillaries in the human body are very fine, the smallest blood vessels can only allow one blood cell to pass through, and the blood cells must change shape when passing through small blood vessels to facilitate the passage, when the deformability of blood cells is weakened. It is difficult to pass small blood vessels, affecting the blood flow velocity, thus increasing the blood viscosity.
5 dyslipidemia: Since the blood is circulating throughout the body, the blood's own viscosity can be changed when the lipid content in the blood is too high. In addition, increased blood lipids inhibit fibrinolysis and increase blood viscosity consistency. Increased blood viscosity is conducive to the occurrence of coronary heart disease, and even induce acute myocardial infarction.
Examine
an examination
Related inspection
Ventilation and perfusion ratio (V/Q) blood routine
Can be diagnosed by hemorheology. The blood is thick and the flow rate is slowed down. In this way, lipids in the blood deposit on the inner wall of the blood vessel, resulting in narrowing of the lumen and insufficient blood supply, leading to diseases such as myocardial ischemia, cerebral thrombosis, and limb blood vessel thrombosis. Some middle-aged and elderly people often feel dizziness, drowsiness, memory loss, etc., which is always considered to be an inevitable phenomenon of life's decline. In fact, this is the result of hyperviscosity.
The main performance in the early days: 1 morning dizziness, awake at night. 2 Difficult after lunch. 3 squatting and working short. 4 paroxysmal vision blurred. When the body is tested for blood, the tip of the needle is often blocked and the blood is quickly aggregated in the needle tube; when the blood rheology is measured, the blood viscosity is "+++" or more, and other indexes are also significantly increased.
Diagnosis
Differential diagnosis
1. High testosteroneemia: In the follicular phase of the normal menstrual cycle, the serum testosterone concentration is 0.43 ng/ml on average, and the upper limit is 0.68 ng/ml, such as more than 0.7 ng/ml (=2.44 nmol/L), ie, high androgen blood. Symptoms, also known as high testosteroneemia. It is a common gynecological endocrine disease. More common are menstrual changes such as menstrual thinning, amenorrhea or dysfunctional uterine bleeding, no ovulation, infertility. Some have masculine changes, such as hairy, enlarged throat, and low pitch. Some obesity, hemorrhoids, breast dysplasia, poor uterine development, ovarian enlargement, a few cases of clitoris hypertrophy.
2, hyperuricemia: also known as gout (gout), is a group of diseases caused by metabolic disorders, its clinical features are hyperuricemia (hyperuricemia) and the resulting recurrent gouty acute arthritis, Tophi deposits, tophus chronic arthritis and joint deformities often involve the formation of chronic interstitial nephritis and uric acid kidney stones in the kidney. The disease can be divided into two major categories: primary and secondary. The cause of primary disease is mostly unclear due to a small number of enzyme defects. It is often accompanied by hyperlipidemia, obesity, diabetes, hypertension, arteriosclerosis and crown. Heart disease, etc., is a hereditary disease. Secondary people can be caused by a variety of causes such as kidney disease, blood diseases and drugs.
3. Hyperhomocysteinemia: At the end of the 1960s, McCully discovered pathologically that patients with homocystinuria and cystathione can develop systemic atherosclerosis and thrombosis in the early stage. At the beginning of the decade, he confirmed through animal models that accumulation of homocysteine blood can cause similar vascular damage. In the 1980s, hyperhomocysteinemia was proposed as an independent risk factor for atherosclerosis and coronary heart disease.
4. Hypercapnia: It is a protective strategy that has been recognized and confirmed. Children with respiratory failure are allowed to have a certain degree of elevation of PaCO2 to avoid lung damage caused by high tidal volume and hyperventilation. This strategy has achieved good results in the treatment of certain lung diseases in adults, such as adult respiratory distress syndrome (ARDS), chronic airway obstruction, and mechanical ventilation in patients with bronchial asthma, significantly reducing air leaks, lung parenchymal damage, and offline difficulties. The occurrence of complications. In the hyaline membrane disease of premature infants, the incidence of barotrauma and bronchial lung dysplasia (BPD) is significantly reduced.
5, hyperammonemia: severe liver damage, urea synthesis disorders lead to increased blood ammonia concentration. When the blood ammonia is increased, the blood ammonia is usually 234.8 to 587 mol/L (400 to 1000 g/dl), and the normal value is 27 to 82 mol/L (46 to 139 g/dl). When hyperammonemia is coma, blood ammonia can be as high as 352.2 to 1526.2 mol/L (600 to 2600 g/dl). Can be diagnosed by hemorheology. The blood is thick and the flow rate is slowed down. In this way, lipids in the blood deposit on the inner wall of the blood vessel, resulting in narrowing of the lumen and insufficient blood supply, leading to diseases such as myocardial ischemia, cerebral thrombosis, and limb blood vessel thrombosis. Some middle-aged and elderly people often feel dizziness, drowsiness, memory loss, etc., which is always considered to be an inevitable phenomenon of life's decline. In fact, this is the result of hyperviscosity.
