Hemoreoloji ve Patofizyolojik Önemi
Hemoreoloji, kan akımının davranışını inceleyen ve son yıllarda klinisyenlerin de ilgisininoldukça arttığı bir bilim dalıdır. Hemoreolojik incelemelerde kullanılan başlıca parametreler;hematokrit (Hct), tam kan ve plazma viskozitesi, eritrosit deformabilitesi ve eritrositagregasyonudur. Kanın akış davranışının, uygun doku perfüzyonunun sürdürülmesinde önemlibir belirleyici olduğu, uzun zamandan beri inceleme konusu olmuş ve yapılan araştırmalarda,kardiyovasküler hastalıklar, diyabet ve paraproteinemi gibi çeşitli patolojik durumlarda,hemoreolojik parametrelerin değişiklikler gösterdiği bildirilmiştir. Kanın akış özelliklerinin;kan akışına ve doku perfüzyonuna katkısı, birçok araştırmanın konusu olmuştur. Kanınakışkanlığının, doku perfüzyonuna etkisini gösteren deneysel bulgular, klinik değerlendirmeleriçin temel oluşturmaktadır ve birçok klinik çalışmada, kan akışkanlığı ile kan dolaşımı ile ilgilisorunların şiddeti arasındaki ilişki doğrulanmıştır. Bu derlemede de, patofizyolojik koşullaraözel önem verilerek, kan reolojisinin rolü ile ilgili deneysel ve klinik veriler gözden geçirilmiştir.
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- 1. Copley AL. Fluid mechanics and biorheology,
Biorheology 1990; 27(1): 3-19.
2. Merrill EW. Rheology of blood. Physiol Rev
1969; 49(4): 863-88.
3. Baskurt OK, Meiselman HJ. Blood rheology
and hemodynamics, Semin Thromb Hemost 2003;
29(5): 435-50.
4. Ertan NZ. Hemoreoloji ve klinik önemi. Tıp
Fakültesi Mecmuası 1995; 58: 1-4.
5. Guyton&Hall Tıbbi Fizyoloji.12.Basım
İstanbul: Nobel Tıp Kitabevleri; 2013.
6. Holsworth RE Jr, Cho YI, Weidman JJ et al.
Cardiovascular benefits of phlebotomy: relationship
to changes in hemorheological variables. Perfusion
2014; 29(2): 102-116.
7. Lowe GDO, Barbenel JC. Plasma and blood
viscosity. Clinical Blood Rheology 1988, 1: 11-44.
8. Cokelet GR, Meiselman HJ. Blood rheology.
In: Baskurt OK, Hardeman MR, Rampling MW,
Meiselman HJ. Handbook of Hemorheology and
Hemodynamics. Washington, DC: IOS Press; 2007.
45-71.
9. Stoltz JF, Singh M, Riha P. Hemorheology in
Practice. Wahington DC: IOS Press; 1999
10. Rosencranz R, Bogen SA. Clinical laboratory
measurement of serum, plasma and blood viscosity.
Am J Clin Pathol 2006; 125: 78-86.
11. Somer T, Meiselman HJ. Disorders of blood
viscosity. Ann Med 1993; 25: 31-39.
12. Chien S.Red cell deformability and its
relevance to blood flow. Annu Rev Physiol 1987;
49: 177-192.
13. Schmid-Schönbein H, Wells RE, Goldstone J.
Fluid drop like behaviour of erythrocyte-disturbance
in pathology in its quantification. Biorheology
1971; 7: 227-234.
14. Rampling MW, Red cell aggregation and yield
stress, In: Lowe GDO, ed. Clinical Blood Rheology.
Boca Raton,FL. CRC Press; 1988. p11-44.
15. Baskurt OK, Meiselman HJ, Erythrocyte
aggregation: basic aspects and clinical importance.
Clin Hemorheol Microcirc 2013, 53(1-2): 23-37.
16. Baskurt OK, Meiselman HJ. Iatrogenic
hyperviscosity and thrombosis. Semin Thromb
Hemost 2012; 38(8): 854-64.
17. Feher G, Koltai K, Kesmarky G et al.
Hemorheological parameters and aging. Clin
Hemorheol Microcirc 2006; 35(1-2): 89-98.
18. Tikhomirova A, Oslyakkova AO, mMikhailova
SG. Microcirculation and blood rheology in patients
with cerebrovascular disorders. Clin Hemorheol
Microcirc 2011; 49(1-4): 295-305.
19. Cho YI, Mooney MP, Cho DJ. Hemorheological
disorders in diabetes mellitus. J Diabetes Sci
Technol 2008; 2(6): 1130-8.
20. Meiselman HJ, Baskurt OK. Hemorheology
and hemodynamics: Doveandare? Clin Hemorheol
Microcirc 2006; 35(1-2): 37-43.
21. Isbister JP. The stress polycythaemia syndromes
and their haemorheological significance. Clin
Hemorheol Microcirc 1987; 7(2): 159-79.
22. Rampling MW. Hyperviscosity as a
complication in a variety of disorders. Semin
Thromb Hemost 2003; 29(5): 459-65.
23. Lowe GDO. Rheology of paraproteinemias
and leukemias, In: Lowe GDO, ed. Clinical Blood
Rheology. Boca Raton, FL. CRC Press;1988. 67-
88.
24. Késmárky G, Kenyeres P, Rábai M, Tóth
K. Plasma viscosity: A forgotten variable. Clin
Hemorheol Microcirc 2008; 39(1-4): 243-6.
25. Kwaan HC. Role of plasma proteins in whole
blood viscosity: A brief clinical review. Clin
Hemorheol Microcirc 2010; 44(3): 167-76.
26. Baskurt OK, Neu B,Meiselman HJ. Red Blood
Cell Aggregation, Boca Raton, Florida: CRC Press;
2012.
27. Tillmann W, Friedrichs E, Germs J, Conrad A.
Increased erythrocyte aggregation in infections –
influence of acute phase proteins. Onkologie 1983;
6: 246-247.
28. Almog B, Gamzu R, Almog R et al. Enhanced
erythrocyte aggregation in clinically diagnosed
pelvic inflammatory disease. Sex Transm Dis 2005;
32(8): 484-6.
29. Goldin Y, Tulshinski T, Arbel Y et al.
Rheological consequences of acute infections:
The rheo difference between viral and bacterial
infections. Clin Hemorheol Microcirc 2007; 36(2):
111-9.
30. Ami RB, Barshtein G, Zeltser D et al.
Parameters of red blood cell aggregation as
correlates of the inflammatory state. Am J Physiol
Heart Circ Physiol 2001; 280(5): 1982-8.
31. Berliner AS, Shapira I, Rogowski O, et al.
Combined leukocyte and erythrocyte aggregation
in the peripheral venous blood during sepsis. An
indication of commonly shared adhesive protein(s).
Int J Clin Lab Res 2000; 30(1): 27-31.
32. Lee BK, Durairaj A, Mehra A et al.
Hemorheological abnormalities in stable angına
and acute coronary syndromes. Clin Hemorheol
Microcirc 2009; 41(1): 81-2.
33. Foresto P, D’Arrigo M, Filippin F, et al.
Hemorheological alterations in hypertensive
patients. Medicina (B Aires). 2005; 65(2): 121-5.
34. Hacioglu G, Yalcin O, Bor Kucukatay M et al.
Red blood cell rheological properties in various rat
hypertension models. Clin Hemorheol Microcirc
2002; 26(1): 27-32.
35. Mantskava M, Momtselidze N, PargalavaN,
Mchedlishvili G. Hemorheological disorders in
patients with type 1 or 2 diabetes mellitus and foot
gangrene. Clin Hemorheol Microcirc 2006; 35(1-
2): 307-10.
36. Solá E, Vayá A, Simó M et al. Fibrinogen,
plasma viscosity and blood viscosity in obesity.
Relationship with insülin resistance. Clin
Hemorheol Microcirc 2007; 37(4): 309-18.
37. Baskurt OK, Pathophysiological Significance
of Blood Rheology. Turk J Med Sci 2003; (33):
347-55.
38. Moon JS, Kim JH, Kim JH, et al. Impaired RBC
deformability is associated with diabetic retinopathy
in patients with type 2 diabetes. Diabetes Metab
2016; 42(6): 448-452.
39. Connes P, Alexy T, Detterich J et al. The role
of blood rheology in sickle cell disease. Blood
Rev 2016; 30(2): 111-8.
40. Vayá A, Suescun M, Hernández JL, et al.
Rheological red blood cell behaviour in minor
α-thalassaemia carriers. Clin Hemorheol Microcirc
2011; 48(4): 241-6.