中老年高血压患者同型半胱氨酸水平与血栓前状态的关系  

Correlation between levels of hemocysteine and the markers of prothrombotic state in elderly patients with hypertension

作　　者：费鲜明[1] 卢飞凤[1] 吴建国[1] 

机构地区：[1]浙江省人民医院检验医学中心,杭州310014

出　　处：《中国临床保健杂志》2009年第4期337-339,共3页Chinese Journal of Clinical Healthcare

基　　金：浙江省医学重点学科基金(07-010)

摘　　要：目的探讨中老年高血压患者同型半胱氨酸(Hcy)检测的临床意义及与血栓前状态的关系。方法分别检测56例高血压患者和20例健康对照者血Hcy、纤维蛋白原(Fib)、D-二聚体(D-D)、组织型纤溶酶原激活物(t-PA)、纤溶酶原活化剂抑制物-1(PAI-1)、蛋白C(PC)、血管性血友病因子(vWF)以及血小板P-选择素(CD62p)。结果高血压患者组Hcy、Fib、D-D、vWF、t-PA及CD62p水平均显著高于健康对照组,PC和PAI-1水平显著低于健康对照组(P<0.01)。高Hcy水平及继发性高血压患者组Hcy、Fib、D-D、vWF、t-PA和CD62p水平分别显著高于(PC和PAI-1低于)正常Hcy及原发性高血压患者组(P<0.01)。高血压程度越严重,Hcy、Fib、D-D、vWF、t-PA和CD62p水平越高,PC和PAI-1水平相应越低(P<0.01)。Hcy与Fib、D-D、vWF、t-PA、CD62p和收缩压呈显著正相关,与PC和PAI-1呈显著负相关(P<0.05或P<0.01)。结论Hcy与中老年高血压患者血栓前状态有关,Hcy检测对评估高血压患者的血栓形成危险性具有重要价值。Objective To evaluate the clinical values of homocysteine and explore the correlation between plasma homocysteine and prothrombotic state in elderly patients with hypertension. Methods Samples from 56 patients and 20 healthy controls were determinated for the levels of homocysteine （ Hcy）, fibrinogen （ Fib）, d-dimer （ D- D）, von Willebrand factor （vWF）, tissue plasminogen activator （t-PA）, plaminogen activator inhibitor-1 （PAI-1）, protein C （ PC ） and p-selectin （CD62p）. Results Compared with the controls, there were elevated levels of plasma Hcy, Fib, D-D, vWF, t-PA and CD62p, and reduced levels of PC and PAI-1 in patients with hypertension. The levels of Hcy, Fib, D-D, vWF, t-PA and CD62p in patients with high Hcy and secondary hypertension were significantly higher （but lower for PC and vWF） than those in patients with normal Hcy and essential hypertension, respectively. Higher blood pressure was, more remarkably the levels of plasma Hcy, Fib, D-D, vWF, t-PA and CD62p increased, and more markedly the levels of PC and PAI-1 decreased. There was positive correlation between Hcy and any one of Fib, D-D, vWF,t-PA and CD62p,and negative correlation between Hey and PC as well as PAI-1. Conclusions Hcy is associated with prothrombotic state in elderly patients with hypertension. The phasma Hcy level is a valuable indicator for the prevention and evaluation of thrombosis in patients with hypertension.

关 键 词：高血压 半胱氨酸 血栓形成 老年人 

分 类 号：R544.1[医药卫生—心血管疾病]