高血压和冠心病患者组织因子途径的改变

目的 观察高血压和冠心病患者血浆组织因子（TF）、组织因子途径抑制物（TFPI）、凝血因子VII（FVII：C、FVIIa）的变化，探讨血浆TF、TFPI、FVII在组织因子途径的改变。方法 FVII：C测定采用一期凝固法，FVIIa测定采用重组可溶性组织因子法；以发色底物法测定TF、TFPI活性。观察对象包括38例高血压，40例冠心病患者以及35名健康正常人。结果 高血压和冠心病患者血浆TF与TFPI的活性高于正常对照组（P〈0．001），但TF增高程度较TFPI更为显著，故均存在TF／TFPI比值升高；且高血压、冠心病患者血浆FVII：C、FVIIa均高于正常对照组（P〈0．01），FVIIa／FVII：C比值亦增大。与高血压组相比，冠心病组TF／TFPI比值增高更为明显（P〈0．001），但FVIIa／FVII：C比值并无显著性差异（P〉0．05）。结论 高血压和冠心病患者TF／TFPI、FVIIa／FVII：C比值增高，提示存在一定的高凝倾向；并且冠心病这种倾向更为严重。

Changes of Tissue Factor Pathway in Patients with Hypertension and Coronary Heart Disease

Objective To observe the changes of tissue factor(TF), tissue factor pathway inhibitor(TFPI) and factor VII (FVII:C and FVIIa) activities in patients with hypertension and coronary heart disease(CHD). Methods FVII: C was determined by a one-stage clotting assay and FVIIa by recombinant soluble TF assay; the activities of TF and TFPI were determined by chromogenic substrate assay. Observation subjects included 38 patients with hypertension, 40 with CHD and 35 healthy volunteers. Results Compared with the control, the levels of TF and TFPI activities in patients with hypertension and CHD were remarkably higher (P<0.001), and the increment of TF was remarkably higher than that of TFPI that was resulted in the enlargement of TF/TFPI ratio. The levels of FVIIa and FVII: C in patients with hypertension and CHD were higher (P<0.01) and FVIIa/FVII: C ratio was also enhanced. In contrast to the hypertension group, the elevation of TF/TFPI ratio in the CHD group was more remarkable (P<0.001); but the elevation of (FVIIa/FVII):C ratio between these two groups showed no significant difference (P>0.05). Conclusions The hypercoagulant tendency exists in the patients with hypertension and CHD, which is relatively more serious in CHD.