恶性高血压患者血浆高敏C反应蛋白、血管性血友病因子和血管性血友病因子裂解酶的变化及意义  

The change of plasma high sensitivity C-reactive protein,von Willebrand factor and von Willebrand factor-cleaving protease in patients with malignant hypertension

作　　者：李长红[1] 郑斌[1] 李振海[1] 

机构地区：[1]佳木斯大学附属第一医院,黑龙江154002

出　　处：《中华高血压杂志》2011年第1期57-60,共4页Chinese Journal of Hypertension

摘　　要：目的探讨恶性高血压肾损害患者血浆高敏C反应蛋白(hsCRP)、血管性血友病因子(vWF)、血管性血友病因子裂解酶(vWF-cp)的变化及意义。方法根据1999年世界卫生组织/国际高血压学会(WHO/ISH)高血压及恶性高血压诊断标准入选恶性高血压肾损害患者28例,单纯高血压患者40例。选择同期健康体检者60例作为正常对照。全自动生化分析仪测定血糖、血脂等指标。免疫比浊法测定hsCRP含量。酶联免疫吸附试验(ELISA)测定血浆vWF浓度,残余胶原结合力试验测定血浆vWF-cp活性水平。同时测定vWF-cp抗体水平。结果高血压患者血浆vWF、hsCRP水平均高于正常对照组(均P<0.01)。恶性高血压组vWF及hsCRP水平均高于单纯高血压组[vWF(142.4±36.5)%比(118.6±36.4)%;hsCRP(10.20±2.80)比(2.46±0.56)mg/L;均P<0.01]。单纯高血压组与恶性高血压肾损害组血浆vWF-cp活性均明显低于正常对照组[分别为(96.1±25.7)%,(86.9±28.0)%比(105.3±15.7)%;均P<0.01]。恶性高血压与单纯高血压组vWF-cp活性无明显差异(P>0.05)。所有患者均未检测到vWF-cp抗体。Pearson相关分析表明,vWF与年龄、脉压和高血压危险度分层呈正相关;vWF-cp与年龄、高血压危险度分层呈弱正相关。结论高血压患者血浆hsCRP、vWF水平升高,恶性高血压肾损害患者升高更明显。单纯高血压组与恶性高血压肾损害组血浆vWF-cp活性均明显低于正常对照组。高血压患者vWF-cp活性下降与该酶抗体无关。Objective To evaluate the changes and significance of plasma high sensitivity C-reactive protein（hs-CRP）,von Willebrand factor（vWF）,von Willebrand factor-cleaving protease（vWF-cp）activity in patients with malignant hypertension presenting with renal damage.Methods Twenty-eight patients with malignant hypertension presenting with renal damage and 40 patients with essential hypertension（EH）were selected according to the 1999 WHO/ISH diagnostic code of hypertension and malignant hypertension.Automatic biochemistry analyzer was used to detect the levels of plasma creatinine,glucagon,cholesterol and triacylglycerol concentration.hs-CRP was detected by immunonephelometry.Enzyme linked immunosorbent assay（ELISA）and residual-collagen binding assay（R-CBA）were used to respectively detect the vWF,vWF-cp activity and their antibodies.All results were compared with 60 normal controls.Results Levels of plasma hs-CRP and vWF in patients with hypertension were higher than those in normal control group and lower than those in patients with malignant hypertension [vWF：malignant hypertension（142.4±36.5）% vs hypertension（118.6±36.4）%;hsCRP：malignant hypertension（10.20±2.80）vs hypertension（2.46±0.56）mg/L;both P〈0.01].Compared with normal controls,plasma vWF-cp activity in both patients with malignant hypertension presenting with renal damage and patients only with EH were significantly decreased [（96.1±25.7）%,（86.9±28.0）% vs（105.3±15.7）%;both P〈0.01].There was no difference between patients with malignant hypertension and patients with EH in the level of plasma vWF-cp activity（P〉0.05）.Antibody was not detected in all these patients.Pearson correlation analysis showed that vWF was positively correlated with age,pulse pressure and hypertension risk stratification;vWF-cp was positively correlated with hypertension risk stratification and age.Conclusion Levels of plasma hs-CRP,vWF were increased in patients with hypertension,especially in patients with malignant hyp

关 键 词：高血压 高敏C反应蛋白 血管性血友病因子 血管性血友病因子裂解酶 

分 类 号：R544.1[医药卫生—心血管疾病]