高血压病患者血小板活化标志物和凝血活性的检测及临床意义

Detection of platelet activation marker and blood clotting activity in patients with hypertension and its clinical significance

目的:研究原发性高血压病患者血栓前状态分子标志物CD62P的表达量、血浆纤维蛋白原(Fib)浓度及凝血酶原时间(PT)、活化的部分凝血活酶时间(APTT)、凝血酶时间(TT)的变化,为临床早期诊断与治疗血栓性并发症提供理论依据。方法:选择53例原发性高血压病患者(Ⅰ级组17例,Ⅱ级组16例,Ⅲ级组20例)及28名健康体检者(对照组),应用流式细胞术分别测定血小板活化分子(CD62P和CD61)的表达量,同时应用Class凝固法分别测定血浆Fib浓度及PT、APTT、TT水平。结果:原发性高血压病患者组CD62P的表达量、血浆Fib浓度高于对照组(P<0.01),PT、APTT、TT水平低于对照组(P<0.05);Ⅱ、Ⅲ级高血压病组CD62P的表达量高于Ⅰ级高血压病组(P<0.01);Ⅲ级高血压病组血浆Fib浓度高于Ⅰ、Ⅱ级组(P<0.01);Ⅱ、Ⅲ级高血压病组PT、APTT、TT水平低于Ⅰ级高血压病组(P<0.05);CD61的表达量在各组间比较差异均无显著性(P>0.05)。结论:高血压病患者血小板活化程度和凝血活性明显增高,存在血栓前状态;对高血压病患者应定期监测上述指标,以便早期防治血栓栓塞性并发症的发生。

Objective To investigate the changes of molecule markers of pre-thrombotic state,expression of CD62P,concentration of plasma fibrinogen（Fib）,prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT） in the patients with essential hypertension for providing theoretical evidence for diagnosis and therapy of thrombus complication in early clinical stage.Methods Fifty-three patients with hypertension（grade Ⅰ 17 cases,grade Ⅱ 16 cases,grade Ⅲ 20 cases）were selected and twenty-eight people with medical examination in good health were used as control group.The expressions of CD62P and CD61 were measured by flow cytometry.The concentration of Fib and the levels of PT,APTT,TT were measured by Class coagulation method.Results The expression of CD62P and the concentration of plasma Fib in essential hypertension group were higher than those in control groups（P〈0.01）.The levels of PT,APTT,TT in essential hypertension group were lower than those in control groups（P〈0.05）.The expressions of CD62P in essential hypertension grade Ⅱand Ⅲ groups were obviously higher than that in essential hypertension grade Ⅰ group（P〈0.01）.The concentration of plasma Fib in essential hypertension grade Ⅲ groups was significantly higher than those in essential hypertension grade Ⅰ and Ⅱgroups（P〈0.01）.The levels of PT,APTT,TT in essential hypertension grade Ⅱ and Ⅲ groups were obviously lower than those in essential hypertension grade Ⅰ group（P〈0.05）.There was no difference of the expression of CD61 between any groups（P〉0.05）.Conclusion The essential hypertensive patients are in pre-thrombotic state,the activation of platelet and blood clotting activity increase.Molecular markers should be measured in essential hypertensive patients for prevention and treatment of thrombotic disease.