[Hemorheology and microcirculation in some pathologies of internal medicine].
OBJECTIVE
It is very interesting in physiopathology to evaluate the blood flow in the microvasculature of patients affected by diabetes, arterial hypertension, lipoproteinosis, peripheral occlusive arterial disease (POAD) and liver failure.


METHODS
We studied 4 groups. Group 1: controls formed by 25 healthy subjects (15 males and 10 females aged 36+/-3 years); group 2: diabetes, including 32 patients (group 2A, 20 subjects with diabetes type 1: 12 males and 8 females aged 43+/-4 years and group 2B, 12 subjects with diabetes type 2: 6 males and 6 females aged 45+/-3 years); group 3: liver failure, formed by 6 subjects (3 males and 3 females aged 44+/-5 years); group 4: hypertensives, 50 subjects (group 4A, 28 smokers 12 males and 16 females aged 40+/-4 years and group 4B, 22 non-smokers: 12 males and 10 females aged 38+/-3 years). We evaluated the capillary morphology using computerized videocapillaroscopy, the hemorheology (red blood cell RBC deformability and aggregability) using LORCA (Laser assisted Optical Rotational Red Cell Analyzer) and tissue oxygenation using transcutaneous oxymeter (Periflux 5000 Perimed). Statistical analysis were performed using the Student t-test.


RESULTS
The capillary loops in patients with diabetic microangiopathy had in 50% of the patients studied an image such as ''deer horns'', as ''elephant nose'' in 72% and as ''cork screw'' in 44%. In diabetics we found also a capillary rarefaction in 28% of them. An improvement in perfusion was observed in patients with liver failure one week after liver transplantation from cadaver in 83% of them. Morphological alterations were present in hypertensives (27% in non-smokers, 46% in smokers). The RBC deformability evaluated as elongation index (EI) and RBC aggregability (t1/2 expressed in seconds) were detected using LORCA. Group 1: EI 0.59+/-0.02, t1/2 3+/-1 s; group 2A: EI 0.55+/-0.01; t1/2 2+/-0.5 s p<0.05 vs controls; group 2B: EI 0.56+/-0.01; t1/2 2+/-0.2 s p<0.04 vs controls; group 3: EI 0.56+/-0.02, t1/2 2+/-0.4 s p<0.04; group 4A: EI 0.56+/-0.02, t1/2 2+/-0.6 s p<0.03; group 4B: 0.57+/-0.02, t1/2 2+/-0.6 s p<0.04. We evaluated also the TcpO2 at the dorsum of the right foot expressed in mmHg: group 1, 96+/-11 mmHg; group 2A, 74+/-9 p<0.05 vs controls; group 2B, 76+/-8 mmHg p<0.05; group 3, 69+/-6 mmHg p<0.05; group 4A, 70+/-5 mmHg p<0.05; group 4B, 77+/-9 mmHg p<0.05.


CONCLUSIONS
This study indicates an interesting and complete methodology in order to evaluate the microcirculation condition in different pathologies inducing microvasculature alterations.
Cicco
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CEMOT, Centro Interdipartimentale di Ricerca in Emoreologia, Microcircolazione, Trasporto di Ossigeno e Tecnologie ottiche non invasive, Università degli Studi di Bari, Bari. gcicco.emo@tiscali.it
Cicco
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D000328:Adult; D002196:Capillaries / Q000473:pathology; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology; D004903:Erythrocyte Aggregation; D004907:Erythrocyte Deformability; D005260:Female; D018056:Hemorheology; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000503:physiopathology*; D017078:Laser-Doppler Flowmetry; D017093:Liver Failure / Q000097:blood / Q000503:physiopathology*; D008297:Male; D008833:Microcirculation / Q000503:physiopathology*; D008875:Middle Aged; D012907:Smoking / Q000097:blood / Q000503:physiopathology