[Central hemodynamic disorders and rheological red blood cell properties in hemorrhagic fever patients with renal syndrome].

The aim of this study was to detect a relationship between hemodynamic disorders in patients with hemorrhagic fever with the renal syndrome (HFRS) and erythrocyte aggregability and erythrocyte membrane ATPase activity. A total of 100 patients with HFRS of different severity were examined. Central hemodynamic parameters were studied: circulating blood volume, minute volume, cardiac index, stroke volume, and total peripheral vascular resistance during preoliguria, oliguria, and polyuria periods. Blood parameters were studied: percentage of minimum and maximum aggregation, disaggregation coefficient, activities of transport adenosine triphosphatases (Na, K, and Ca-activated ATPases and Mg-dependent ATPase). The main hemodynamic parameters were increased (p < 0.05) during early preoliguria and decreased during oliguria; during the polyuria period they again corresponded to the hyperkinetic circulation. The minimum erythrocyte aggregation increased by 110 and 130% in medium-severe and severe HFRS, respectively, the maximum erythrocyte aggregation by 20 and 28%, respectively (p < 0.05). Disaggregation coefficient decreased by 55%. The activities of Na, K(+)-ATPases decreased by 13% during preoliguria period, by 17.5% during oliguria, and by 11.7% during polyuria (p < 0.05) in patients with moderate disease. In severe disease these decreases were 14, 19, and 15%, respectively (p < 0.05). Similar changes were observed in the activities of Ca(++)-ATPase and Mg-dependent ATPase. Hence, the detected hemodynamic changes in patients with medium-severe and severe HFRS correlated with disorders in erythrocyte aggregability and decreased activity of transport ATPases, which can be used for evaluation of the severity of clinical condition and early diagnosis.