高血压颈动脉斑块阳性患者纤溶功能与血小板活化的变化

目的了解原发性高血压颈动脉斑块(PH+CP)阳性患者血清纤溶功能与血小板活化指标的变化及其临床意义。方法检测56例PH+CP组患者血清组织型纤溶酶原激活物(tPA)、纤溶酶原激活物抑制物(PAI)、P-选择素(Ps)和血管性血友病因子(vWF)水平,并与50例健康体检者(对照组)和53例单纯原发性高血压(PH组)患者比较。结果 PH+CP组血清Ps、PAI和vWF水平分别为(43.47±13.19)pg/L、(1.53±0.36)Au/ml、(197.42±48.65)%,PH组分别为(35.72±12.13)pg/L、(0.87±0.33)Au/ml、(144.53±36.47)%,对照组分别为(25.43±10.97)pg/L、(0.59±0.34)Au/ml、(98.89±37.61)%,PH+CP组各项检测值高于PH组;PH组各项检测值高于对照组(P<0.01)。tPA水平:PH+CP组为(0.46±0.35)μg/L、PH组为(0.77±0.41)μg/L、对照组为(0.99±0.42)μg/L,PH+CP组低于PH组,PH组低于对照组(P<0.01)。结论高血压伴颈动脉斑块阳性患者有抗凝纤溶功能损害现象,并有血小板黏附与聚集,这种表现可能与高血压常见血管事件的发生与发展有关联。

The relationship of fibrinolytic function and platelet activation in patients with hypertension associated with carotid plaque

Objective To study serum fibrinolytic function and laboratory markers of platelet activation and their clinical significance in patients with primary hypertension associated with carotid plaque(PH+CP).Methods In PH+CP group of 56 patients,the following markers were measured: serum tissue plasminogen activator(tPA),plasminogen activator inhibitor(PAI),P-selectin(Ps) and von Willebrand factor(vWF).The comparisons of the mentioned above markers levels among PH+CP group and 50 healthy participants(control group) and primary hypertension group(PH group without carotid plaque,n=53) were performed.Results Serum Ps,PAI and vWF levels in PH+CP group were(43.47±13.19)pg/L,(1.53±0.36)Au/ml,(197.42±48.65)%,respectively;in PH group,they were(35.72±12.13)pg/L,(0.87±0.33)Au/ml,(144.53±36.47)%,respectively;in control group,they were(25.43±10.97)pg/L,(0.59±0.34)Au/ml,(98.89±37.61)%,respectively;the comparison of the mentioned above markers among PH+CP group and PH group and control group showed that PH+CP group in the scores of the mentioned above levels were higher than PH group,and PH group were higher than control group(P<0.01).The measrement of tPA level: PH+CP group was(0.46±0.35)μg/L,PH group was(0.77±0.41)μg/L,and control group was(0.99±0.42)μg/L,PH+CP group was lower than PH group,PH group was lower than control group(P<0.01).Conclusion Patients with primary hypertension associated with carotid plaque have anticoagulant and fibrinolytic function disorders,accompanied with platelet adhesion and aggregation,this manifestation may be related to the genesis and development of common vascular events in hypertension.