高血压病患者血栓前状态P-选择素等标志物变化及其临床意义

Levels of P selectin and its clinic significance in hypertensive patients with prothrombotic status

目的通过检测原发性高血压患者血小板表面P-选择素(CD62P)和血浆纤维蛋白原(Fg)水平,了解血小板活化百分率与血栓栓塞性并发症的相关因素。方法采用病例对照研究,运用流式细胞仪定量检测60例原发性高血压患者及20例健康对照组的血小板活化指标CD62P的表达量,运用Clause血凝法检测血浆纤维蛋白原水平。结果①病例组血小板CD62P和血浆纤维蛋白原水平显著高于对照组(P<0.01)。②血小板CD62P表达量和血浆纤维蛋白原水平在高血压2级、3级明显高于对照组和高血压1级(P<0.05)。③高血压高危、极高危组血浆纤维蛋白原水平明显高于低危组及对照组,差别有统计学意义(P<0.01),且高于中危组,但差别无统计学意义(P=0.26)。中危组血浆纤维蛋白原水平显著高于对照组,差别有统计学意义(P<0.01)。④血小板CD62P表达量在高血压高危组、中危组明显高于低危组和对照组(P<0.01),且高危组高于中危组(P<0.05)。⑤CD62P与收缩压(r=0.59,P<0.01)、舒张压(r=0.43,P<0.01)有正相关关系。结论高血压患者特别是高血压高危、极高危组较正常健康人血小板CD62P的活化百分率明显增高,且CD62P的活化百分率和血压存在一定的相关性。

Objective To observe the changing of platelet activity marker（CD62P） and the serum level of fibrinogen （Fg） in patients with hypertension, and assess its clinic significance of markers changing in the happening of thrombotic disease. Methods CD62P were measured by flow cytometry in 60 patients with hypertension （HT）, and 20 healthy control. The serum level of fibrinogen were measured at the same time. The comparison of the value changing among the four groups was conducted. Results （1）The value of CD62P on the surface of platelet membrane in hypertension group was significantly increased comparing with control group （P〈0.01）and the plasma levels of Fg was higher than control group （P〈0.01）o （2）The expression value of CD62P on the surface of platelet membrane and the plasma levels of Fg in hypertension groups with grade 2,3 were significantly increased comparing with the groups of control and hypertension grade 1 respectively. （3）The plasma levels of Fg in hypertension with higher risk group and highest risk group were significantly increased comparing with control group and low risk group （P〈0.01）. （4）The value of CD62P in hypertension with higher risk,highest risk were significantly increased comparing with the two groups of the low risk group and the control group respectively （P〈0.01）. （5）The CD62P level has a positive correlation with blood pressure level （SBP：r=0.59,P〈0.01;DBP：r=0.43,P〈0.01）.Conclusion There is increased markers of prothrombotic state in the groups of grade 2,3 hypertension which relates to the levels of blood pressure and risk factors.