老年高血压病患者白细胞流变性和细胞粘附分子表达的变化

Changes of Leukocyte Rheologic Characteristics and Expression of Cellular Adhesion Molecule in Aged Patients with Hypertension

为探讨白细胞流变性和细胞粘附分子表达与老年高血压病患者病情变化的关系，应用细胞变形能力测定仪、体外血栓血小板粘附两用仪及酶联免疫吸附法检测１０４ 例老年高血压病患者和５６ 例健康老年人外周血白细胞变形能力、白细胞粘附功能、白细胞 Ｃ Ｄ１８ 表达、血清可溶性细胞间粘附分子－ １ 及可溶性血管细胞粘附分子－ １ 浓度的变化，并进行对比分析。结果发现，老年高血压病患者的白细胞滤过指数、白细胞粘附率、白细胞 Ｃ Ｄ１８ 表达、血清可溶性细胞间粘附分子－ １ 及可溶性血管细胞粘附分子－ １ 浓度均高于健康老年人，差异有极显著性（ Ｐ＜ ０ ．００１） 。老年高血压病患者上述各项指标随病情严重程度增加而增高。老年高血压病患者白细胞滤过指数与白细胞粘附率呈正相关（ｒ ＝ ０ ．５６２ ， Ｐ＜ ０ ．００１） ，白细胞滤过指数和白细胞粘附率与白细胞 Ｃ Ｄ１８ 表达、血清可溶性细胞间粘附分子－ １ 和可溶性血管细胞粘附分子－ １ 浓度呈正相关（ｒ＝ ０ ．５７９ ～０ ．８１６ ， Ｐ＜ ０ ．００１） 。结果提示，白细胞变形能力降低，白细胞粘附功能、白细胞 Ｃ Ｄ１８ 表达、血清可溶性细胞间粘附分子－ １ 和可溶性血管细胞粘附分子－ １ 浓度增高与老年高血压病的发生?

Aim To explore the changes of leukocyte rheologic characteristics and cellular adhesion molecules (CAMS) expression in aged patients with hypertension. Methods By using the erythrocyte deformability apparatus, thrombus and platelet adhesion dual-purpose apparatus and enzyme linked immunosorbent assay (ELISA) methods, the leukocyte deformability (LD), leukocyte adhesion function (LAF), leukocyte CD18 expression, serum soluble intercellular adhesion molecule-1 (sICAM-1) concentration and serum soluble vascular cellular adhesion molecule-1 (sVCAM-1) concentration were measured in 104 aged patients with hypertension and 56 controls. Results The leukocyte filtration index (LFI), leukocyte adhesion rate (LAR), leukocyte CD18 expression, sICAM-1 concentration and sVCAM-1 concentration were significantly higher in aged patients with hypertension than those in controls (P<0.001). Remarkable differences of these parameters were found in patients with three stages (P<0.001), and the most obvious increase of the changes was found in stage Ⅲ. In aged patients with hypertension, the LFI was positively related to the LAR (r=0.562,P<0.001), LFI and LAR were positively related to leukocyte CD18 expression, sICAM-1 concentration and sVCAM-1 concentration (r=0.579～0.816,P<0.001). Conclusion It showed that the decrease of LD and the increase of LAF, leukocyte CD18 expression, sICAM-1 concentration and sVCAM-1 concentration might participate in the pathogenesis of hypertension.