血栓形成标志物与原发性高血压的关系

Study on relationship between markers of thrombotic state and hypertension

目的判断原发性高血压患者是否存在血栓前状态(pretbrombotic state,PTS),并探讨PTS在原发性高血压患者中的意义.方法运用酶联免疫吸附双抗体夹心法(ELISA)、酶联免疫吸附竞争法、发色底物法、凝固法等检测手段,检测了1 000例原发性高血压患者和100例健康成人的6-酮-前列腺素F1α(6-K-PGF1α)含量、血栓素B2(TXB2)含量、纤维蛋白原(Fib)含量、组织型纤溶酶原激活剂(t-PA)及纤溶酶原激活抑制物-1(PAI-1)的含量和活性及血液流变学等指标的变化进行分析与评价.结果与对照组比较,1～2级高血压组及3级高血压组患者血浆TXB2、Fib水平、PAI-1含量及活性、血黏度均显著升高(P＜0.01);而6-K-PGF1α含量、t-PA含量及活性均显著下降(P＜0.01).结论高血压病患者存在PTS,PTS与高血压病患者的病情发展,血栓栓塞性疾病的发生密切相关.

Objective To investigate whether there is prethrombotic state （PIS） in hypertensive patients and the significance of PIS in essential hypertension. Methods A series of molecular markers, that is, thromboxane B2 （ TXB2 ）, 6-keto-prostaglandin F1α （6-K-PGF1α）, fibrinogen （Fib）, tissue-type plasminogen activator （ t- PA） and its inhibitor （PAI-1） were measured in 1 000 patients with 1st-, 2nd- and 3rd- degree essential hypertension and 100 normal controls by radioimmunoassay, the chromogenic substrate and the enzyme linked immunosorbent asssy （ELISA） respectively. The indexes of hemorheology were also studied in the subjects. Re- sults As compared with controls, plasma levels of TXB2, Fib, PAI- 1 activity, blood viscosity were found to be significantly higher （ P 〈 0.01 ） in hypertensive patients; but 6-K-PGF1α and t-PA activity were lower （ P 〈 0.01 ）. Conclusion Prethrombotic state is present in hypertensive patients and may be associated with increased blood pressure. This explains in part why the thrombotic complications are common in hypertensive patients.