高血压患者微循环改变及与血小板聚集性的关系

Relation between Changes of Microcirculation and Platelet Aggregation from Patients with Hypertension

目的了解高血压患者微循环的改变及与血小板聚集性的相关性。方法采用ＸＤＭ３００－Ｂ型彩色甲襞微循环仪和ＴＹＸＮ－９１智能血液凝集仪对９４例不同程度的高血压患者进行微循环的观察及血小板功能测定。结果（１）高血压组的微循环总积分值明显高于对照组（Ｐ＜０．０１）。（２）高血压Ⅰ期时仅有一项粒缓流的异常发生率较对照组明显增高，Ⅱ、Ⅲ期高血压分别与对照组及与Ⅰ期高血压比较，各项主要指标均有显著性差异，但Ⅱ期与Ⅲ期之间比较仅粒缓流存在显著差别，其他指标则无显著性差异。（３）高血压的微循环中度及重度异常组的血小板聚集性１ｍｉｎ、５ｍｉｎ及最大聚集率分别与对照组比较呈显著差异，中度及重度异常组之间相比较，５ｍｉｎ及最大聚集率均呈显著差异，分别为６６．４５±１１．２８（Ｐ＜０．０５），７６．５２±１６．３１（Ｐ＜０．０１），二者正相关。（４）微循环异常总积分值越高，血小板的最大聚集率也越高（ｒ＝０．４２４２，Ｐ＜０．０１）。结论高血压患者微循环障碍程度与高血压患者的血小板聚集性呈正相关关系，两种检查结合可作为临床抗凝、降低血粘度治疗的重要监测手段之一。

Aim To investigate the relationship between changes in microcirculation and platelet aggregation in patients with hypertension. Methods Using a system of colour microscope and computer analysis(XDM300 B) and instrument of multiple function blood aggregation(TYXN 91), the changes of nailfold microcirculation and platelet aggregation ratio were observed in 94 cases of hypertensive patients in different stages. Results (1) The total integral scores of nailfold microcirculation in hypertension group were significantly higher than control group (P<0 01). (2)In the patients of stage Ⅰ,the incidence rate of slow granular flow was obiviously higher than taht in control group. The main indices of microcirculation in patients of stage Ⅱ and stage Ⅲ hypertension were higher than that in patients of stageⅠ,but there was no significantly different between the stage Ⅱ and stage Ⅲ group. (3) The 1 minute, 5 minutes and maximum platelet aggregation ratio were evidently increased in hypertensive patients with moderate and severe abnormal microcirculation. (4) The higher the total integral scores of microcirculation,the more the maximum aggregation ratio of platelet(r=0.4242, P<0 01). Conclusion The degree of abnormalities of microcirculatory were positively correlated with function of platelet in patients with hypertension. Combination of two monitoring in treatment of hypertension may be of potentially important.