【摘要】 目的 探讨老年人肺源性心脏病(肺心病)并发低渗血症及高粘血症的诊断与治疗对策。 方法 对20例经血浆渗透压及血液流变学检查，证实有低渗血症并高粘血症的老年肺心病患者进行回顾性分析。 结果 本组低渗血症并高粘血症轻度及中度各8例，重度4例，多见于肺心病危重病例。治疗后症状缓解15例，死亡5例，病死者为中至重度低渗血症并高粘血症。 结论 由于临床症状无特异性，老年肺心病并发低渗血症及高粘血症容易漏诊，应引起注意。治疗上应和肺心病的其他并发症同步进行，以减少肺心病患者的死亡。

Blood hypoosmolality andhyperviscosaemia in 20 aged patients with cor pulmonale

LI Zongqin. Department of Internal Medicine,Affiliated Hospital Bengbu Medical College, Anhui 233000

【Abstract】 Objective To investigatethe diagnosis and treatment of blood hypoosmolality and hyperviscosaemia in aged patientswith cor pulmonale. Methods Hypoosmolality and hyperviscosaemiaproved by plasma osmotic pressure and hemorheology were analysed in 20 aged patients withcor pulmonale. Results Hypoosmolality and hyperviscosaemia were foundin 20 severe cor pulmonale. Eight mild cases and 8 moderate cases (osmotic pressure260-280 mmol/L and 240-259 mmol/L, hematocrit >0.50 and 0.55) 4 severe cases (osmoticpressure<240 mmol/L,hematocrit>0.60).After treatment, symptoms of the disease werealleviated in 15 patients and 5 patients died of mild to high degree blood hypoosmolalityand hyperviscosaemia. Conclusions It is notable that because of lackof characteristic clinical manifestations, blood hypoosmolality and hyperviscosaemia areeasily to be missed in diagnosis. Treatment of the above conditions should be consideredduring managing complications of cor pulmonale so as to decrease mortality of the disease.

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