Investigation of Hemorheological Parameters in Ischemic Stroke Patients.

Gursan Gunes Uygun, Sena Ebru Caglar, Kemal Tutkavul, Esra Gurdal Kosem, Yunus Karakoc
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Abstract

Background: The aim of this study is to determine whether there are any changes in hemorheological parameters, including whole blood viscosity (WBV), plasma viscosity, erythrocyte aggregation, and erythrocyte deformability, in acute ischemic stroke patients, and to establish their relationship with stroke etiology. The study also aims to observe the changes in these parameters, if any, over time and after treatment, and to assess the correlation between risk factors for ischemic stroke and neuroimaging findings.

Methods: This was a prospective observational study including 70 patients diagnosed with acute ischemic stroke within the first 3 days of the onset of symptoms and 96 healthy controls. Stroke patients were categorized based on TOAST criteria, and hemorheological parameters were measured at admission and on the fifth day post-treatment. Erythrocyte aggregation and deformability were measured using a laser ektacytometer, and viscosity assessment was conducted with a rotational viscometer.

Results: Stroke patients exhibited significant differences from the control group in aggregation amplitude, aggregation index, and aggregation half-time (p = 0.001, p = 0.013, p = 0.009, respectively) and showed elevated maximum value of elongation index (p = 0.000). No significant differences in WBV and plasma viscosity were observed between the groups. Post-treatment, the small vessel occlusion subgroup demonstrated a notable reduction in WBV. Additionally, homocysteine levels showed a positive correlation with scattered white matter lesions in basal ganglia and infratentorial regions (p = 0.002, p = 0.039, respectively).

Conclusions: Increased predisposition to erythrocyte aggregation may contribute to the occurrence of acute ischemic stroke. Moreover, gaining the ability of erythrocytes to deform and increase blood flow may serve as a compensatory mechanism in the chronic vascular disease process. The risk factors for ischemic stroke may exhibit connections to specific areas within the brain.

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缺血性中风患者血液流变学参数调查
研究背景本研究旨在确定急性缺血性卒中患者的血液流变学参数(包括全血黏度(WBV)、血浆黏度、红细胞聚集性和红细胞变形性)是否发生变化,并确定其与卒中病因的关系。研究还旨在观察这些参数随时间和治疗后的变化(如果有的话),并评估缺血性中风危险因素与神经影像学结果之间的相关性:这是一项前瞻性观察研究,包括 70 名在发病后 3 天内被诊断为急性缺血性脑卒中的患者和 96 名健康对照者。根据 TOAST 标准对脑卒中患者进行分类,并在入院时和治疗后第五天测量血液流变学参数。红细胞聚集性和变形性是用激光电子血细胞计数器测量的,粘度评估是用旋转粘度计进行的:结果:脑卒中患者的聚集振幅、聚集指数和聚集半衰期与对照组相比均有显著差异(分别为 p = 0.001、p = 0.013、p = 0.009),且延伸指数的最大值升高(p = 0.000)。各组间的 WBV 和血浆粘度无明显差异。治疗后,小血管闭塞亚组的 WBV 显著降低。此外,同型半胱氨酸水平与基底节和脑下垂体区域的散在白质病变呈正相关(分别为 p = 0.002 和 p = 0.039):结论:红细胞聚集的易感性增加可能会导致急性缺血性脑卒中的发生。此外,获得红细胞变形和增加血流量的能力可能是慢性血管疾病过程中的一种代偿机制。缺血性中风的危险因素可能与大脑中的特定区域有关。
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