血栓前状态与原发性高血压关系的临床研究

Clinical study on relationship between prethrombotic state and essential hypertension.

目的通过观察原发性高血压患者血栓前状态(PTS)分子标志物的变化,探讨其易并发血栓性疾病的机制,为临床早期诊治提供客观依据。方法检测1 000例原发性高血压患者及100例健康对照者血浆PTS分子标志物[血管性血友病因子(vWF)、血浆α-颗粒膜蛋白(GMP-140)、11-去氢血栓烷B2(11-DH-TXB2)、纤维蛋白原(FIB)、抗凝血酶(AT)]的含量,组织型纤溶酶原激活剂(t-PA)、纤溶酶原激活剂抑制物-1(PAI-1)的活性水平及血流动力学指标,并进行分析与评价。结果与正常对照组相比,高血压组患者的血浆vWF、GMP-140、11-DH-TXB2、FIB含量及PAI-1活性和血粘度均明显升高,而AT含量、t-PA活性均明显下降(均为P<0.01)。随着血压水平升高,PTS标志物水平变化越显著(P<0.05)。结论原发性高血压患者存在PTS,PTS与其病情进展及血栓性疾病的发生密切相关。

Objective To evaluate the mechanism of thrombotic complication in essential hypertension patients through observing the changes of the prothrombotic state mocular markers and to provide basis for early diagnosis and treatment. Methods Molecular markers [von Willebrand factor （ vWF ） , GMP-140,11-DH-TXB2, FIB, AT] and tissue-type plasminogenactivator （ t-PA ） , PAI-1, as well as hemodynamic indexes were analyzed. Results vWF, GMP-140,11 -DH-TXB2, FIB and PAL1 activation as well as blood viscosity were significantly increased in hypertension group as compared with control group, while AT level and t-PA activation were significantly decreased （ P 〈0.01 ）. PTS markers level changed significantly with the increase of blood pressure （ P 〈0.05 ）. Conclusion Prethrombotic state exists in patients with essential hypertension, which maybe closely correlated with the disease progression and the development of thrombotic complications.