Hyperviscosity syndrome

Introduction Hyperviscosity syndrome is a series of unique clinical symptoms caused by a significant increase in blood viscosity and an increase in blood fluid dynamics resistance, manifested by ocular fundus expansion, localized stenosis, hemorrhage and exudation, causing visual impairment. Dizziness, vertigo, deafness, numbness of the hands and feet and disturbance of consciousness, severe cases can be coma; abnormalities in heart, lung and kidney function; can cause Raynaud's phenomenon.

Cause

Increased blood viscosity can be seen in the following blood diseases:

1. Significant increase in red blood cells: such as polycythemia vera.

2, red blood cell deformation: sickle cell hemoglobin disease.

3, plasma protein increased significantly: multiple myeloma, macroglobulinemia.

4, increased platelets: such as essential thrombocytosis.

5, increased white blood cells: acute and chronic leukemia.

an examination

Related inspection

Blood routine white blood cell count (WBC) abnormal red blood cell morphology examination hematocrit (HCT) red blood cell examination

Clinical examination:

The blood viscosity is abnormally increased, and the blood tends to be thick, sticky, coagulated, and concentrated. It is manifested as visual dysfunction due to expansion of the fundus vein, localized stenosis, hemorrhage and exudation. Dizziness, vertigo, deafness, numbness of the hands and feet and disturbance of consciousness, severe cases can be coma.

A blood viscous syndrome caused by one or several non-transient increases in blood viscosity factors is called a hyperviscosity syndrome. Divided into five subtypes:

(1) High blood thick type: more common hematocrit increases.

Significance: If the hematocrit is increased, it means that the blood is thick and sticky, and it is found in polycythemia, congestive heart failure, and mountain sickness.

(2) High blood viscosity type: the viscosity of whole blood is increased, the viscosity of plasma is increased, the viscosity of whole blood is increased, the hematocrit is increased, and the fibrinogen content is increased.

Significance: Commonly found in the following diseases, such as polycythemia, coronary heart disease, diabetes, hypertension, chronic bronchitis, vasculitis, pulmonary heart disease, connective tissue disease active period, leukemia, etc.

(3) The accumulation of red blood cells is enhanced: the erythrocyte sedimentation rate is increased, the K value of the erythrocyte sedimentation rate is increased, the erythrocyte aggregation index is increased, and the red blood cell electrophoresis is slowed down.

Such as: cerebral infarction, cardiac infarction, thromboangiitis obliterans.

(4) Rigidity enhancement of red blood cells: The rigidity index of red blood cells is increased, and the deformation index of red blood cells is increased.

Such as: sickle hemoglobin, acidosis.

(5) High blood coagulation type: increased fibrinogen content, increased platelet adhesion rate, and increased platelet aggregation rate.

In vitro thrombosis test: thrombus length, wet weight, dry weight increased.

Differential diagnosis

Identification:

There are five types of blood viscosity increase, and the treatment methods are different because of the different causes of various blood viscosity increases.

(1) Plasma viscosity increase type: blood is removed from the blood cell component. Plasma viscosity is primarily dependent on the protein content in the plasma. When the fibrinogen and globulin in the plasma increase, it can cause an increase in plasma viscosity. This increase in blood viscosity is common in patients with arteriosclerosis and coronary heart disease.

The blood viscosity is generally reduced by blood thinning and plasma exchange, and can be treated with sodium alginate.

(2) Enhanced blood cell aggregation: The increase in blood viscosity of this type is mainly due to the increase in viscosity of platelets and red blood cells themselves. Many platelets and red blood cells stick together, forming tiny emboli, blocking blood vessels, and blood flow is therefore slow. The increase in blood viscosity of patients with hypertension is mostly of this type.

It can be treated with low molecular weight dextran, snake venom preparations and enteric-coated aspirin and dipyridamole to reduce the aggregation of red blood cells and platelets.

(3) Red blood cell deformability reduction type: Red blood cells have a special deformability, that is, the shape is very flexible, so that the capillary vessels which are much thinner than themselves can be passed to ensure the blood flow perfusion and nutrient supply of the microcirculation. Once this deformability is weakened, it will inevitably affect the free movement of red blood cells, increase the red blood cells in the blood, and increase the viscosity of the blood. The blood viscosity of the elderly is increased, mostly related to the decreased ability of red blood cells to deform.

Such blood viscosity increase can be treated with oral karan tablets, anti-suppository pills, and brain stilbene.

(4) High pressure product type: This increase in blood viscosity is due to the excessive number of red blood cells in the blood, which is common in middle-aged people aged 40 to 60 years. Because the red blood cells occupy too much volume in the blood, the blood flow becomes thick, which leads to slow blood flow, affects the blood supply of tissues and organs, and causes various cardiovascular and cerebrovascular diseases.

This increase in blood viscosity due to excessive red blood cells can be treated by hemodilution, and low-molecular dextran and 706-generation plasma are generally used to restore blood viscosity to normal.

(5) Increased viscosity of whole blood: The above-mentioned several factors causing an increase in blood viscosity are simultaneously called an increase in viscosity of whole blood. This type of increase in blood viscosity is more common in patients with diabetes and obesity cardiovascular disease. Generally, long-term comprehensive treatment is needed. In addition to long-term medication, regular infusion is required to dilute the blood.

The increase in whole blood viscosity and plasma viscosity is a comprehensive indicator. It can be said that in addition to blood dilution, it is difficult to find a drug that can lower blood viscosity for various reasons, but Chinese traditional tea beverages have been studied to reduce blood fat and reduce fiber. The proprotein, which inhibits platelet aggregation and the like, lowers the blood viscosity, and the active ingredient tea pigment has been extracted into a medicine.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.