高血压伴腔隙性脑梗死患者动脉弹性功能与血管性假血友病因子的关系

Relation between arterial elasticity and vWF in essential hypertension patients with lacunar infarction

目的探讨原发性高血压伴腔隙性脑梗死患者动脉弹性功能与血浆中血管性假血友病因子(vWF)的关系。方法选择高血压伴腔隙性脑梗死男性患者60例,根据血压控制情况分为血压控制良好组(30例)和血压控制不良组(30例)。应用美国DP200M动脉仪进行肱动脉弹性测定,在美国ACL3000plus凝血分析仪上采用比浊法测定vWF。结果血压控制良好组血管弹性指标(系统动脉顺应性、系统动脉阻力、肱动脉扩张性、肱动脉阻力)明显好于血压控制不良组(P<0.05)。血压控制不良组vWF明显高于血压控制良好组(163.57±40.50)%vs(131.27±30.99)%,再发脑梗死比率增高(30.00%vs6.67%),且血压控制良好与否和vWF增高、血管弹性指标的改变呈正相关(OR=5.00,95%CI:1.51～16.56;OR=6.91,95%CI:2.16～22.10)。结论高血压伴腔隙性脑梗死患者存在血管弹性功能异常,并与vWF的失衡有关。针对性控制血压及进一步控制vWF的失衡对原发性高血压并腔隙性脑梗死患者有益。

Objective To explore the relationship between arterial elasticity and the plasma levels of von Willebrand factor（vWF） in patients suffering from essential hypertension with lacunar infarction. Methods Studies were performed in 60 men with essential hypertension and lacunar infarction. They were divided into well-controlled group（30 cases） and poorly controlled group（30 cases） according to controlling of blood pressure. Arterial elasticity indices were measured by the DP200M meter. The ACL3000 plus blood coagulation analyser was used to measure the plasma vWF level. Results Arterial elasticity indices were better in well-controlled group of hypertension with lacunar infarction than in poorly controlled group （P〈0.05）. The plasma vWF level was higher in poorly controlled group than in well-controlled group [（163. 57±40.50）%vs （131.27±30. 99）%, the rate of recurrence of infarction was also higher（30. 00% vs 6.67%）. There was significant positive correlations between controlling of blood pressure and plasma vWF level and arterial elasticity indices （OR =5. 00,95% CI： 1. 51-16. 56; OR =6. 91,95% CI： 2.16-22.10）. Conclusion Vascular dysfunction is associated with the plasma vWF level disequilibrium in patients with hypertension and lacunar infarction. Control of blood pressure and vWF disequilibrium is beneficial to the essential hypertension patients with lacunar infarction.