止凝血分子标志物变化在老年冠心病合并高血压中的临床意义  

The clinical significance of changes of molecular markers of blood coagulation and hemostasis in old coronary artery disease patients with hypertension

作　　者：马建林[1] 马立宁[1] 张银环[2] 张家明[2] 李大主[2] 林劲[1] 张敬文[1] 王圣[1] 苏哲坦[1] 李斌[1] 陈关良[1] 王卫[1] 

机构地区：[1]海南省人民医院心内科,海南海口570311 [2]华中科技大学同济医学院附属协和医院心内科

出　　处：《中国老年学杂志》2014年第12期3217-3219,共3页Chinese Journal of Gerontology

基　　金：国家自然科学基金课题资助(81160036/H0212);海南省自然基金指导性计划项目(806109);海南省卫生厅科研课题(琼卫2008-37);国家重点建设学科项目资助(2011年)

摘　　要：目的观察止凝血分子标志物在老年冠心病(CAD)合并高血压(HP)中的变化并探讨其临床意义。方法选择老年CAD患者116例,其中稳定性心绞痛(SAP)患者36例(SAP组),不稳定性心绞痛(UAP)患者38例(UAP组),UAP合并HP 42例;另选健康体检者48例(对照组),分别测定血清血管性血友病因子、抗凝血酶Ⅲ、纤溶酶原、血浆α-颗粒膜蛋白、纤维蛋白原、D-二聚体含量,以及血小板膜糖蛋白分子数,并进行统计学分析。结果老年UPA患者各项指标与正常对照组比较均有统计学意义(P<0.05,P<0.01),而老年UAP合并HP患者各项指标也明显高于老年单纯UAP患者(P<0.05,或P<0.01)。结论老年UAP患者存在血栓前状态,其体内存在多种止凝血分子标志物的变化,这种变化在合并HP的老年UAP患者中最突出,可能是导致心肌梗死的重要原因。Objective To observe the changes of molecular markers of blood coagulation and hemostasis in old coronary artery dis -ease ( CAD) patients with hypertension ( HP) and to investigate their clinical significances .Methods 116 old patients with CAD were cho-sen as experiment group, including 36 patients with stable angina pectoris(SAP),38 patients with unstable angina pectoris( UAP), 42 UAP patients with HP.48 volunteers were also chosen as control group , and the levels of vWF, ATⅢ, Plg, GMP-140, Fbg, D-Dimer were meas-ured in all groups.Resutl s Compare with those of control group ,there were significant changes of molecular markers of blood coagulation and hemostasis in old UAP patients (P<0.05,P<0 .01);Compare with those of old UAP patients without HP ,there were significant changes of molecular markers of blood coagulation and hemostasis in old UAP patients with HP (P<0.05,P<0.01).Conclusions There are pre-thrombotic state in old UAP patients , and many factors of the blood might develop coagulation and hemostasis , especially in old UAP pa-tients with HP, which might be an important factor leading to myocardial infarction .

关 键 词：冠心病 高血压 止血 凝血 分子标志物 

分 类 号：R54[医药卫生—心血管疾病]