老年高血压血栓前状态vWF、GMP-140及D-dimer变化研究  

Research on changes of vWF,GMP-140及D-dimer prothrombotic state in elderly essential hypertension

作　　者：吴金花[1] 冯丽珍[2] 

机构地区：[1]武警内蒙古总队医院心内科,内蒙古呼和浩特010040 [2]武警内蒙古总队医院检验科,内蒙古呼和浩特010040

出　　处：《武警医学院学报》2012年第3期167-170,共4页Acta Academiae Medicinae CPAPF

摘　　要：【目的】通过观察老年原发性高血压(essential hypertension,EH)患者血栓前状态(prothrombotic state,PTS)分子标志物的变化,探讨其并发血栓性疾病的机制,为预防或延缓老年EH患者病情的进展提供客观依据。【方法】选择308例老年EH患者为观察组,100例健康老年人为对照组(normal control group,NC),应用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA),测定反映血管内皮细胞损伤的分子标志物血管性血友病因子(von willebrand factor,vWF)、反映血小板激活的血小板α颗粒膜蛋白(α-granule membrane protein,GMP-140)、反映凝血及继发性纤溶系统活性的D-二聚体(D-dimer,DD)的含量,并进行分析与评价。【结果】老年EH患者血浆vWF、GMP-140及DD的含量明显高于对照组(P<0.05),随着血压水平的升高,合并靶器官损伤(target organ damage,TOD)的比例增加,3种分子标志物水平亦升高,与未合并靶器官受累组比较(P<0.05),且vWF、GMP-140及DD的水平之间两两呈正相关(P<0.01)。【结论】老年EH患者存在PTS,容易发生血栓性疾病,应早期监测干预。【Objective】To observe the changes of plasma molecular markers of prothrombotic state in elderly essential hypertension（EH） and to discuss the mechanism of thrombotic diseases,it provides objective evidence for preventing or delaying condition of elderly EH.【Methods】308 elderly patients with essential hypertension were selected as observation group,while 100 healthy elderly as control group.The plasma concentration of von Willebrand factor（vWF）,α-granule membrane protein（GMP-140） and D-dimer（DD）were all measured by enzyme linked immunosorbent assay（ELISA） method,anlysing and evaluating the result.vWF is a factor reflecting the damage degree of vascular endothelial cells,GMP-140 reflecting degree of activation of blood platelet,DD reflecting coagulation and activity of condequental fibinolytic system.【Results】It was found that the levels of plasma von Willebrand factor（vWF）、α-granule membrane protein（GMP-140） and DD were significantly higher in elderly essential hypertensive group than those in controls（P 〈 0.05）.The levels of plasma vWF,GMP-140,DD were higher in patients group with higher blood pressure and more target organ damage than those with lower blood pressure and less target organ damage（P 〈 0.05）.Plasma vWF 、GMP-140 and DD in the patients with essential hypertension were correlated with each other（P 〈 0.01）.【Conclusions】There are prothrombotic state in elderly essential hypertension who easily get thrombotic disease.As a result,they should monitor and intervene the state in the early stage.

关 键 词：老年原发性高血压 血栓前状态 血管性血友病因子 血小板Α颗粒膜蛋白 D-二聚体 

分 类 号：R544.11[医药卫生—心血管疾病]