白大衣高血压患者的血小板功能

Analysis of platelet function in patients with white coat hypertension

目的:探讨白大衣高血压(WCH)患者的血小板功能。方法:选初诊的原发性高血压(EH)患者、WCH患者、正常血压(NT)者各35例,通过诊室血压测量和24h动态血压监测,同时测定并比较3组血小板最大聚集率(PAGTmax)、血浆血小板α-颗粒膜蛋白(GMP-140)含量、平均血小板容积(MPV)、血小板数量的变化。结果:和NT对照组相比,EH组和WCH组PAGTmax、血浆血小板GMP-140含量、MPV均明显增加(P<0.05)而三组血小板计数无统计学差异,同时EH组的PAGTmax、血浆血小板GMP-140含量、MPV均高于WCH组(P<0.05)。EH组和WCH组MPV与24h平均舒张压、GMP-140含量均正相关(P<0.05)。结论:WCH存在血小板活化,可能和心血管事件发生率增加有关。

Objective： To investigate the change of platelet function in patients with essential hypertension （EH）, white coat hypertension （WCH）and normotension （NT）. Method：Participants were classified as EH （n= 40）, WCH （n= 40）, or NT （n： 40） on the basis of clinic and 24 hour ambulatory blood pressure monitoring. The change of maximum platelet aggregation rate（PAGTmax）, the level of platelet alpha-granule membrane pro- tein（GMP-140）and the mean platelet volume （MPV）were measured between the subjects. Result： Compared with NT controls, the PAGTmax, the level of GMP-140 and the MPV were significantly higher in patients with EH and WCH （P〈0.05）, those were also higher in essential hypertensives than in white coat hypertensives（P〈 0.05）. MPV was positively correlated with the level of GMP-140 and the 24 hour ambulatory diastolic blood pres- sure in EH group as well as in WCH group. Conclusion： There exist enhanced platelet activity in WCH by which white coat hypertensive may be at increased cardiovascular risk.