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Red blood cell (RBC) aggregation is the phenomenon consisting of coin-like structures or clumps formation. Cells aggregation plays a crucial role in the blood microcirculation, oxygen delivery, and hemorheology. It is well known that RBC aggregation in pathological conditions is dramatically different compared to the healthy state. Early we found that RBC aggregation is elevated in patients suffering from arterial hypertension (AH), coronary heart disease (CHD), type 2 diabetes mellitus (T2DM), and others. However, the influence of comorbidities on RBC aggregation remains a relatively unclear up to time. This work aims to shed light on the effect of comorbidities on the RBC aggregation measured in vitro by laser-optical techniques. Laser aggregometry implemented in RheoScan device (Korea) was used to measure RBC aggregation parameters. Overall, 235 patients with AH were enrolled in the study. They were divided into four groups. First group enrolled only patients with AH without cardiovascular complications (n = 139); the second group included patients with AH and CHD but without T2DM (n = 59); the third group consisted of patient with AH and T2DM but without CHD (n = 21); and finally, the fourth group included the patients with AH, CHD and T2DM (n = 16). The findings suggest that the presence of comorbidities changes the RBC aggregation properties, i.e., RBC aggregates tend to form more rapidly, and RBC aggregation is enhanced. The obtained results will help develop novel treatment protocols for patients with comorbidities. The study was financially supported by the Russian Science Foundation grant #23-45-00027
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