血小板活化因子在高血压伴心血管危险因素患者中的临床意义

Clinical significance of serum platelet activating factor in hypertensive patients with multi-cardiovascular risk factors

目的探讨血小板活化因子(platelet activating factor,PAF)在原发性高血压(高血压)伴心血管危险因素患者中的临床意义。方法选择在心血管内科门诊诊断为高血压的患者332例,男134例,女198例,年龄(61.4±8.7)岁为研究对象。根据2005年中国高血压防治指南按伴危险因素分层分为4组:Ⅰ组无其他危险因素者50例、Ⅱ组伴1～2个危险因素者134例、Ⅲ组≥3个危险因素或靶器官损害或合并糖尿病者103例、Ⅳ组并存的临床情况者45例;采用酶联免疫吸附测定法对血清PAF浓度进行检测,按PAF不同浓度进行分级,PAF<1ng/mL,5ng/mL<PAF≥1ng/mL,15ng/mL<PAF≥5ng/mL,PAF≥15ng/mL共4级并进行比较。结果血清PAF浓度由低到高例数比例Ⅰ组为40%,42%,10%,8%例;Ⅱ组为68%,42%,25%,9%例;Ⅲ组为12%,14%,34%,41%例;Ⅳ组为9%,20%,31%,40%例。经等级资料秩和检验,采用Kruskal-Wallis秩和检验提示4组之间差异有统计学(χ2=68.959,P=0.000)。等级资料两两比较采用Mann-Whitney Test检验:Ⅰ组与Ⅱ组Z=-2.624,P=0.009;Ⅰ组与Ⅲ组Z=-6.442,P=0.000;Ⅰ组与Ⅳ组Z=-4.940,P=0.000;Ⅱ组与Ⅲ组Z=-6.534,P=0.000;Ⅱ组与Ⅳ组Z=-3.924,P=0.000;Ⅲ组与Ⅳ组Z=-0.827,P=0.408。结论检测PAF浓度对高血压伴心血管疾病危险因素患者的病情评估有一定临床指导意义。

Objectives To explore clinical significance of serum platelet activating factor （PAF） in hypertension patients with multi-cardiovascular risk factors.Methods A total of 332 outpatients （134 male,198 female） were selected from Vasculocardiology Department.Their age were （61.4±8.7 ）years.These cases were divided into 4 groups in accordance with risk grading of 2005 Chinese hypertension prevention and cure guide.I group included 50 cases with no risk factors;Ⅱ group included 134 cases with 1-2 risk factors;Ⅲ group included 103 cases with greater than or equal to 3 risk factors or critical organ impairment,diabetes;IV group included 45 cases with multi-cardiovascular risk factors.Serum PAF contents of all groups were determined and compared by enzyme linked immunosorbent assay （ELISA）.Results Case rate in I group were 40%,42%,10%,8%;in II group were 68%,42%,25%,9%;in Ⅲ group were 12%,14%,34%,41% and in IV group were 9%,20%,31%,40% when serum PAF content was from low to high.Kruskal- Wallis rank sum test indicated that there was a significiently difference among the 4 groups （χ^2=68.959,P=0.000）.Mann- Whitney Test showed that Ⅰgroup toⅡ group Z=-2.624,P =0.009;Ⅰgroup to Ⅲ group Z=-6.442,P=0.000;Ⅰgroup to Ⅳ group Z=-4.940,P=0.000;Ⅱgroup tp Ⅲ group Z=-6.534,P=0.000;Ⅱgroup to Ⅳ group Z=-3.924,P=0.000;Ⅲgroup to Ⅳ group Z=-0.827,P=0.408.Conclusions Detecting PAF content could be a guide to evaluate pathogenetic condition of hypertension with multi-cardiovascular risk factors.