老年高血压患者的血栓前状态分子标志物的改变及临床意义——附100例报告

Changes and clinical significance of prothrombotic state markers in the elderly hypertensive patients

目的:研究老年高血压患者的血栓前状态(prothrombotic state,PTS)分子标志物的变化,为临床早期诊断治疗提供客观依据。方法:测定100例老年原发性高血压患者(高血压组)及100名老年健康人(对照组)的血浆血管性血友病因子抗原(von Willebrand factor antigen,vWF:Ag)、血浆P-选择素、纤维蛋白原(fibrinogen,Fg)、凝血酶原片段1+2(prothrombin fragment1+2,F1+2)的含量,抗凝血酶、组织型纤溶酶原激活物(tissue type plasminogen activator,t-PA)、纤溶酶原激活抑制物-1(plasminogen activator inhibitor-1,PAI-1)的活性,并进行分析与评价。结果:老年Ⅱ、Ⅲ级高血压组病人血浆中vWF:Ag、P-选择素、Fg、F1+2的含量、PAI-1较对照组均明显升高,而抗凝血酶、t-PA较对照组均明显下降,比较差异有统计学意义(均为P<0·01)。结论:老年Ⅱ、Ⅲ级高血压患者存在明显的内皮损伤、血小板活化、高凝状态及抗凝和纤溶活性的降低,即PTS。因此,对这类病人应定期监测上述指标,以便早期防治缺血性心、脑血管疾病。

Objective： To investigate the changes and clinical significance of the prothrombotic state markers in elderly hypertensive patients. Methods： A series of molecular markers including von Willebrand factor antigen （ vWF： Ag）, P-selectin, fibringen （Fg） , prothrembin fragment 1 ＋ 2 （F1 ＋ 2） , anti thrombin （AT） , tissue-type plasminogen activator （t-PA） and plasminogen activator inhihitor-1 （PAI-1） were measured in 100 elderly essential hypertensive patients and 100 elderly normal controls. Re- suits： Plasma levels of vWF： Ag, P-selectin, Fg, F1 ＋ 2 and PAI-1 activity were significantly higher and AT, t-PA activity were significantly lowe in elderly hypertensive patients （ Ⅱ ,Ⅲ ） than those in the normal controls （P 〈0. 01 ）. Conclusion： Elderly hy- pertensive patients （ Ⅱ ,Ⅲ ） are in prothrombotic state with significant endothelium damage, hypercoagulation tendency and de- creased activities of anticoagulation and fibrinolysis. Molecular markers should be measured in the elderly hypertensive patients （ Ⅱ ,Ⅲ ） for prevention and treatment of thrombotic disease.