原发性高血压患者红细胞超微结构和聚集性的改变与血压的关系

目的应用电镜技术观察原发性高血压患者红细胞超微结构和聚集性的改变,探讨其在原发性高血压发病过程中的作用。方法随机选择无伴随疾病的原发性高血压患者36例作为实验组,对照组为12例正常成年人,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。结果扫描电镜下和透射电镜下,原发性高血压组的异常形态红细胞所占比例均显著升高(P<0.05,t=5.11,4.83,3.07,2.98),并与舒张压呈明显正相关,原发性高血压组的比表面积明显减小(P<0.05,t=2.56)。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原发性高血压患者的红细胞聚集现象更加明显。结论血压增高可能与红细胞超微结构的改变有关,红细胞聚集性增高和异常红细胞变形性降低将导致血流动力学发生改变。

Change of ultrastructure and aggregation of erythrocyte in patients with essential hypertension and its correlation with blood pressure

Aim To observe the changes of ultrastructure and aggregation of erythrocyte in essential hypertension (EH) by electron microscope and to investigate the role of erythrocyte in the process of EH episode. Methods Venous blood specimens of 12 healthy subjects, 6 males and 6 females with the average age of(53± 8)years, and 36 hypertension patients without other diseases, 20 males and 16 females with the average age of(58± 8)years, were prepared and examined by scanning electronic microscope(SEM) and transmission electronic microscope (TEM).Erythrocyte specific surface was measured by quadratic test grid.Results Under SEM and TEM, the percentages of abnormal erythrocytes in EH patients increased significantly (P< 0.05,t=5.11,4.83,3.07,2.98), which had a positive correlation with diastolic blood pressure. The erythrocyte specific surface area of the hypertensive group was smaller than that of the control group (P< 0.05,t=2.56). There was an increase in erythrocyte aggregation in the hypertensive group by TEM and SEM, especially in 9 cases with left ventricular hypertrophy.Conclusion The increase of blood pressure may be related to the change of erythrocyte ultrastructure .The increase of erythrocyte aggregation and decrease of erythrocyte deformability result in the change of hemorheology.