原发性高血压患者红细胞形态与聚集性的改变及意义

Electronic microscopic observation and meanings of morphologic and aggregative changes of erythrocyte in hypertension

目的:观察高血压病患者红细胞形态及聚集性的改变,探讨其在高血压病发病过程中的作用。方法:随机选择无伴随疾病的原发性高血压患者30例作为实验组,正常成年人10例为对照组,采取空腹静脉血,制成电镜标本,在扫描电镜和透射电镜下观察,拍照,记数,测试比表面积。结果:扫描电镜下,原发性高血压组的双凹圆盘形红细胞所占比例明显降低,嵴形、口形、类球形红细胞所占比例显著升高(P<0.05)。透射电镜下,高血压组哑铃形红细胞所占比例明显降低(P<0.01),比表面积减少(P<0.01)。并且两种电镜下均发现高血压组呈聚集状态的红细胞显著增多,9例伴有左心室肥厚的高血压病患者的红细胞聚集现象更加明显。结论:高血压病存在红细胞形态改变,表现为异常形态红细胞显著增多和红细胞聚集性增高,比表面积减少,提示高血压病红细胞形态学改变可能是其变形性降低的原因之一。

Objective:To observe the morphologic and aggregative changes of erythrocyte in hypertension and to evaluate the significance of the changes. Methods;Two groups were studied; Group 1 consisted of 30 hypertensives . This group was of medium risk according to WHO and ISH (1999) without diabetes, coronary heart disease, hyperlipoidemia. Group 2 was made up of 10 healthy subjects, venous blood specimens were examined by scanning electronic microscope(SEM) and transmissible electronic microscope ( TEM) . Erythrocyte specific surface was measured by quadratic test grid. Results; Under SEM , percentages of stoma-tocyte , ridgecyte and spherocyte-like erythrocyte in hypertension patients decreased significantly( P < 0. 05). Under TEM , the percentages of dumbbell-like erythrocyte in hypertension are decreased significantly, The erythrocyte specific surface of hypertensive group is smaller than that of control group( P < 0. 05 ) . Under TEM and SEM , there is a increase in erythrocyte aggregation in hypertension, especially in which with left ventricular hypertrophy. Conclusions;The percentages of erythrocyte with abnormal shape in hypertension increase,and erythrocyte specific surface of hypertensives are decrease. There is a increase in erythrocyte aggregation in hypertension, especially in which with left ventricular hypertrophy.