高血压腔隙性脑梗塞患者红细胞形态和ATP酶活性的变化

ATPase Activity and Abnormality of Erythrocyte Morphology in Hypertension Patients with Cerebral Lacuna Infarction

目的探讨红细胞ＡＴＰ酶活性与红细胞形态改变及对高血压并发腔隙性脑梗塞的影响。方法用电镜扫描方法观察３３例高血压及２０例高血压伴腔隙性脑梗塞患者的红细胞形态，并用激光衍射方法及沈茂星法分别测定红细胞变形性及红细胞膜ＡＴＰ酶活性。结果（１）高血压腔梗组口形、嵴形、类球形等异常形态红细胞检出率明显高于高血压组和正常对照组（４．８４±１．６７／２．０４±１．１２／１．４０±０．３３，Ｐ＜０．０１）。（２）高血压腔梗组异常红细胞检出率＞４％者明显高于高血压组（８０％／９．１％，Ｐ＜０．００１）。（３）高血压腔梗组红细胞最大变形指数（ＤＩｍａｘ）及综合变形指数（ＩＤＩ）均低于正常组（Ｐ＜０．０５）。（４）高血压腔梗组及高血压组红细胞膜Ｎａ＋－Ｋ＋－ＡＴＰ酶活性与Ｃａ２＋－Ｍｇ２＋－ＡＴＰ酶活性（μｍｏｌ·ｇＨｂ－１·２ｈ－１），均明显低于正常对照组（Ｐ＜０．０１）。结论高血压患者红细胞膜ＡＴＰ酶活性降低的同时红细胞几何形态出现异常，并伴有红细胞变形性减低，是腔隙性脑梗塞的原因之一。因此，高血压的防治除降压，抗血小板等治疗外，还应给予改善ＡＴＰ酶活性，促使红细胞形态正常化的治疗。

Aim\ To investigate ATPase activity of erythrocyte membrance and morphology abnomality of erythrocyte in hypertension patients with cerebral lacunar infarction.\ Methods\ Erythrocyte morphology from 33 patients with hypertension and 20 hypertension patients with cerebral lacunar infarction were investigated by scanning electronic microscope,erythrocyte deformability and ATPase activity of erythrocyte membrane were examined .\ Results\ (1)In hypertension patients with cerebral lacunar infarction(CLI) the detecting rate of abnormality of erythrocyte morphology was higher than that in hypertension group and normal group(484±167/204±112/140±033, P<0001);(2)in CLI group, 80% patients had abnormal RBC>4%, which is much greater than that in hypertension group.(3)Deformation indexes (DImax and IDI)were lower in CLI group and hypertension group than that in normal group(P<005).(4)Both CLI group and hypertension group, the activity of Na +K +ATPase and Ca 2+ Mg 2+ ATPase of erythrocyte membrane were lower than that in normal group(P<001).\ Conclusion\ In patients of hypertension with cerebral lacunar infarction, the decrease of ATPase activity in erythrocyte membrane usually associated with deformation of erythrocytes. Treatment to improve the activity of ATPase and normalize the erythrocytes morphology might be benefical to hypertension patients.