血栓前状态分子标志物的变化在不稳定型心绞痛合并高血压患者中的价值

目的探讨血栓前状态(PTS)分子标志物变化在不稳定型心绞痛(UAP)合并高血压(HBP)患者中的价值。方法选取我院2012年1月~2015年12月心脏中心重症监护室收治的120例UAP患者按照随机对照原则分为UAP组50例,UAP合并HBP组70例,另选50例无器质性心脏病的在院老年患者作为对照组,用酶联免疫吸附双抗体夹心法(ELLSA)、发色底物法、免疫浊度法等检测方法分别对3组患者PTS分子标志物进行测定分析,包括:血管性血友病因子抗原(v WF:Ag)、血小板α颗粒膜蛋白-140(GMP-140)、组织型纤溶酶原激活剂(t-PA)、血浆纤维蛋白原(Fbg)、纤溶酶原激活抑制物-1(PAI-1)、抗凝血酶(AT)及血液流变学等指标。结果 UAP组的血浆v WF、GMP-140、Fbg含量、PAI-1含量及活性均明显高于对照组、低于UAP合并HBP组,UAP组的AT含量、t-PA活性均明显低于对照组,高于UAP合并HBP组,差异具有统计学意义(P0.05);血压越高,PTS标志物变化越显著(P0.05)。结论 1UAP合并HBP者存在PTS;2UAP合并HBP者的PTS变化较单纯UAP者更为明显;3PTS分子标志物变化可加速血栓形成。

Value of Changes in Molecular Markers on Patients with Unstable Angina Combined with High Blood Pressure under Prothromboticstates

Objective To explore the value of molecular markers on patients with unstable angina pectoris (UAP) combined with high blood pressure (HBP) under prothromboticstates (PTS).Methods One hundred and twenty patients with UAP admitted in the intensive care unit,Heart Center of the Hospital were divided into UAP Group with 50 patients and UAP in combination with HBP group with 70 patients in randomized and controlled principle,and another 50 elderly patients admitted without organic heart disease were divided into the control group,enzyme linked immunosorbent double antibody assay (ELLSA),chromogenic substrate assay,imunoturbidimetry assay and other detection methods were applied to respectively analyze and determine PTS molecular markers of patients in three groups,including:antigen of von willebrand factor (vWF:Ag),platelet-α granule membrane protein-140 (GMP-140),tissue-type plasminogen activator (t-PA) and plasma fibrinogen (Fbg),fibrinolytic enzyme activation inhibitor-1 (PAI-1),antithrombin (AT) and blood rheology indicators.Results The plasma vWF,GMP-140,Fbg content and content and activity of PAI-1 of patients in the UAP group were significantly higher than such indexes of patients in the control group and lower corresponding results of UAP and HBP,AT content and t-PA activity of patients in UAP group were significantly lower than such indicators of patients in the control group and higher than corresponding indicators of UAP combined with HBP group,the differences were statistically significant (P ＜ 0.05);The higher the blood pressure was,the changse in PTS markers were more significant (P ＜ 0.05)).Conclusion ① PTS exists in patients with UAP combined HBP;② the change in PTS of patients in HBP combined UAP group is more significant when compared to that of relatively simple UAP;③ PTS molecular markers can accelerate thrombosis.