3. 血管壁障害と血液レオロジー

抄録

Reports expressing concern over hemorheological factors in recent studies of diabetic microangoiopathy (DmA) are on the increase. To elucidate the pathogenesis of DmA, hemorheological factors (HRF) such as whole blood and plasma viscosities, platelet adhesion and aggregation, maximum dynamic rigidity modulus of blood clot and plasma fibrinogen concentration were studied in 29 normal subjects and 149 patients with diabetes mellitus. Diabetic patients showed significant differences in all HRF when compared with those of normal subjects. Even in non-retinopathic diabetics, a third of the subjects showed significant abnormality in each of these HRF. And this paper concerns some studies that attempt to correlate intravascular erythrocyte aggregation (IEA) in eye bulbar conjunctiva with the extent of hemorheological abnormalities and the severity of retinopathy in diabetics. In the cases where a high degree of IEA were observed in vessels of the conjunctiva, there were many of advanced retinopathy or involved with blood disorders. Further we studied the fiterability of red cells in diabetics by using the negative pressure filteration system. A significant increase of HbA₁ was suggested to be closely related to the decrease of red cell fiterability. These abnormalities of HRF would lead to interference with microcirculation of retinal vessels to cause local hypoxia and microangiopathy in diabetics.