原发性高血压患者血浆vWF含量与微量蛋白尿关系的研究  

Circulating vWF and Microalbuminuria in Essential Hypertensive Patients

作　　者：谢萍[1] 雷仁义[2] 王恒大[2] 

机构地区：[1]甘肃省人民医院心内科,甘肃兰州730000 [2]兰州医学院第一附属医院心内科

出　　处：《高血压杂志》2002年第1期53-55,共3页Chinese Journal of Hypertension

摘　　要：目的　研究原发性高血压 (EH)患者血浆vWF含量变化与微量蛋白尿 (MAU)之间的联系及其决定因素。方法　入选 5 5例EH(Ⅰ、Ⅱ期 )患者 ,并按 2 4小时尿白蛋白排泄量将其分为两个亚组即 :伴MAU组及不伴MAU组 ;31例健康对照。测定其反映血管内皮功能损害的指标 -血浆vWF值、2 4小时尿白蛋白排泄量 ,同时对其血浆组织型纤溶酶原激活物 (t PA)、纤溶酶原激活抑制物 1(PAI 1)及其纤维蛋白原 (Fbg)含量、血压 (BP)、体重指数 (BMI)、血脂及血肌酐 (Scr)等指标进行测定。结果　伴MAU的EH患者比不伴MAU的EH患者以及健康对照的血浆vWF水平明显升高 ,有显著性差异 (P <0 0 5 ) ,个体的血压、vWF值及尿白蛋白排泄率呈正相关。伴MAU的EH患者血浆Fbg含量升高并与vWF值升高水平相关。另外 ,循环中vWF水平、MAU与病情程度呈正相关。结论　在EH患者vWF值升高与MAU同时存在 ,并且两者间存在联系 ,说明MAU可反应血管内皮功能障碍 ,即血管内皮功能障碍是两者联系的确定因素。此外 ,伴MAU的EH患者Fbg及vWF含量升高 ,说明其血液凝固性增加。Objective To investigate the relationship between circulating von Willebrand factor(vWF) and microalbuminuria in essential hypertensive patients, and to evaluate the possible determinants of this association. Methods Circulating vWF, a indicator of endothelial dysfunction and 24 hours urinary albumin excretion were measured in 55 patients with essential hypertension.\ 31 healthy subjects matched age, sex, weight index served as controls. The blood pressure(BP), body mass index(BMI) and serum lipid, serum creatine, t PA, PAI-1, Fbg concentrations were measured. Results vWF values were higher in hypertensive patients without microalbuminuria and controls, vWF were correlated with urinary albumin excretion.\ Blood pressure positively related with both vWF and urinary albumin excretion. Fibrinogen was raised in microalbminuria and correlated with vWF level. Conclusions Microalbuminuria and increased vWF levels usually coexist in patients with essential hypertension, indicating that microalbuminuria reflects a systemic dysfunction of vascular endothelium function. Hypercoagulability was associated with essential hypertensive patients complicated with microalbuminuria.

关 键 词：原发性高血压 微量蛋白尿 内皮功能障碍 von WILLEBRAND因子 EH 血管内皮细胞 

分 类 号：R544.1[医药卫生—心血管疾病]