H型高血压患者血管的结构功能及其血栓前分子标记物的变化

The Changes in the Structure and Function of Blood Vessels and Pre-thrombotic Molecular Markers in Patients with H-type Hypertension

目的根据同型半胱氨酸(Hcy)的水平,对H型、非H型高血压患者以及健康人群的血管的结构功能以及血栓前分子标记物含量变化进行比较并对其机制进行初步探析。方法选取2016至2017年在我院确诊为原发性高血压患者230例作为研究对象,根据其Hcy水平分为两组,其中Hcy>10μmol/L称为H型组,共计100例,而Hcy≤10μmol/L则为非H型组,共计130例,同时选取80例健康人群作为对照组,比较组间患者的血管的结构功能以及血栓前分子标记物含量变化。结果相比于非H型组高血压患者,H型组的斑块更大同时数目较多,且颈动脉内中膜厚度较厚,具有显著性差异(P<0.05);同时对两组患者的颈动脉斑块进行分级比较,我们发现H型组高血压患者比非H型组在3级程度上所占比例显著增高,0级程度较低;H型高血压组患者的无论是左侧还是右侧的ba PWV相比于非H型组都有明显升高,且差异具有统计学意义(P<0.05);与健康人群的对照组相比,可以明显看到两组高血压患者的GMP-140、vWF、Fbg、D-dimer的含量都具有显著上升,差异具有统计学意义(P<0.05),与非H型组高血压患者相比而言,H型组患者的血栓前分子标记物也具有明显的上升(P<0.05)。结论高水平的Hcy会使原发性高血压患者的动脉血管的结构与功能都发生改变,主要表现在降低患者血管弹性的同时产生血管斑块,并且血栓前分子标记物含量的增高,提示了患者的血液处于高凝状态。

Objective According to the level of homocysteine （ Hcy）, compare the changes of the structure and function of blood vessels and the changes of molecular markers before and after thrombosis in H- type, non-H-type hypertensive patients and healthy people. Methods 230 patients With primary hypertension diagnosed in our hospital from January 2015 to January 2016 were selected as the subjects. According to their Hcy levels,when Hcy 〉 10μmol/L was called H group,A total of 100 cases,and Hey ≤10μmol/L was non- H group,a total of 130 cases,while 80 healthy people as a control group, compared between the group of patients with vascular structure and function and pre-thrombotic markers changes. Results Compared with non-H group hypertensive patients, the number of spots in the H-type group was larger and the thickness of the carotid intima- media was thicker, and there was significant difference （ P 〈 0. 05 ） ; At the same time, the carotid plaques of the two groups were compared ,we found that patients with H-type hypertension than non-H- type group in the tertiary level accounted for a significant increase in the level of 0 to a lower level;Patients with type H hypertension had significantly elevated baPWV compared to non-H-type, whether left or right; Compared with the healthy control group, the levels of GMP-140, vWF, Fbg and D-dimer in the two groups of hypertensive patients were significantly increased, and the difference was statistically significant （P 〈 0. 05 ）, However, in patients with non-H-type hypertension compared with H-type group of patients with prethrombotic markers also showed a significant increase in the difference was significant （P 〈 0. 05 ）. Conclusion High levels of Hcy will make the structure and function of arterial vessels in patients with essential hypertension have changed, mainly in reducing blood vessel elasticity at the same time produce vascular plaque,And an increase in pre-thrombotic molecular markers suggests that the patient＇ s blood is in a hypercoagulable state.