高血压伴高同型半胱氨酸患者血管内皮细胞损伤的相关标志物水平变化观察
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摘要
目的分析高血压伴高同型半胱氨酸(Hcy)患者血管内皮细胞损伤及血栓前状态的相关标志物水平变化的临床诊断价值。方法选取我院收治的高血压伴高Hcy患者80例为观察组,选择同期Hcy水平正常的原发性高血压患者60例为对照组,选择同期门诊体检健康者40例为正常组。比较三组研究对象的血管内皮细胞损伤及血栓前状态的相关标志物的水平情况。结果观察组患者Hcy、血栓调节蛋白(TM)、超敏C反应蛋白(hs-CRP)、血管性假性血友病因子(v WF)、血小板α颗粒膜蛋白-140(GMP-140)、纤溶酶原激活物抑制物-1(PAI-1)、纤维蛋白原(FIB)、D-二聚体(D-D)水平明显高于对照组与正常组(均P <0. 05),而叶酸、维生素B12及组织型纤溶酶原激活物(t-PA)水平明显低于对照组与正常组(均P <0. 05)。结论高血压伴高Hcy患者的Hcy、TM、hs-CRP、v WF、GMP-140、PAI-1、FIB、D-D水平较高,而叶酸、维生素B12、t-PA水平较低。
Objective To investigate clinical diagnostic value of the changes of related markers of vascular endothelial cell injury and prothrombotic state in patients with hypertension and hyperhomocysteinemia. Methods 80 hypertensive patients with hyperhomocysteinemia who received treatment in our hospital were selected as obeservation group. 60 patients with primary hypertension who had normal homocysteine( Hcy) levels were enrolled as control group. 40 healthy? people in the outpatient clinic were selected as the normal group. The levels of related markers of vascular endothelial cell injury and prethrombotic state were compared in the three groups. Results Hcycytosine( Hcy),thrombomodulin( TM),hypersensitive C-reactive protein( hs-CRP),von Willebrand factor( v WF),platelet alpha granule membrane Protein-140( GMP-140),plasminogen activator inhibitor-1( PAI-1),determination of fibrinogen( FIB),D-dimer( DD) levels in observation group were significantly higher than the other two groups( all P < 0. 05),however the levels of folic acid,vitamin B12 and tissue plasminogen activator( t-PA) were significantly lower than the other two groups( all P < 0. 05). Conclusions The levels of Hcy,TM,hs-CRP,v WF,GMP-140,PAI-1,FIB and D-D were higher in patients with hypertension and hyperhomocysteinemia while the levels of folic acid,vitamin B12 and t-PA were lower.
Objective To investigate clinical diagnostic value of the changes of related markers of vascular endothelial cell injury and prothrombotic state in patients with hypertension and hyperhomocysteinemia. Methods 80 hypertensive patients with hyperhomocysteinemia who received treatment in our hospital were selected as obeservation group. 60 patients with primary hypertension who had normal homocysteine( Hcy) levels were enrolled as control group. 40 healthy? people in the outpatient clinic were selected as the normal group. The levels of related markers of vascular endothelial cell injury and prethrombotic state were compared in the three groups. Results Hcycytosine( Hcy),thrombomodulin( TM),hypersensitive C-reactive protein( hs-CRP),von Willebrand factor( v WF),platelet alpha granule membrane Protein-140( GMP-140),plasminogen activator inhibitor-1( PAI-1),determination of fibrinogen( FIB),D-dimer( DD) levels in observation group were significantly higher than the other two groups( all P < 0. 05),however the levels of folic acid,vitamin B12 and tissue plasminogen activator( t-PA) were significantly lower than the other two groups( all P < 0. 05). Conclusions The levels of Hcy,TM,hs-CRP,v WF,GMP-140,PAI-1,FIB and D-D were higher in patients with hypertension and hyperhomocysteinemia while the levels of folic acid,vitamin B12 and t-PA were lower.
引文
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[2]Hobbelt AH,Spronk HM,Crijns HJGM,et al. Prethrombotic state in young very low-risk patients with atrial fibrillation[J]. J Am Coll Cardiol,2017,69(15):1990-1992.
[3]方宇,刘惠莲,杨克平,等. H型高血压患者血管的结构功能及其血栓前分子标记物的变化[J].血栓与止血学,2018,24(2):197-200.
[4]Yaghootkar H,Lotta LA,Tyrrell J,et al. Genetic evidence for a link between favorable adiposity and lower risk of type 2 diabetes,hypertension,and heart disease[J]. Diabetes,2016,65(8):2448-2460.
[5]孙宁玲,李建平,卢新政,等. H型高血压诊断标准依据解读[J].中华高血压杂志,2017,25(6):508-510.
[6]倪云忠.老年H型高血压合并糖尿病患者血浆同型半胱氨酸水平与颈动脉内膜厚度关系的研究[J].中国实验诊断学,2017,21(10):1770-1772.
[7]Mao X,Xing X,Xu R,et al. Folic acid and vitamins D and B12 correlate with homocysteine in Chinese patients with type-2 diabetes mellitus,hypertension,or cardiovascular disease[J]. Medicine,2016,95(6):e2652-e2659.
[8]纪昕,岳晓乐,赵丹丹,等.同型半胱氨酸与动脉粥样硬化患者血管内皮细胞损伤相关性[J].标记免疫分析与临床,2017,24(1):73-76.
[9]Azegami T,Yuki Y,Hayashi K,et al. Intranasal vaccination against angiotensin II type 1 receptor and pneumococcal surface protein A attenuates hypertension and pneumococcal infection in rodents[J]. J Hyper,2018,36(2):387-394.
[10]柳相珍,张媛,徐成伟,等.子痫前期患者血浆中可溶性内皮细胞蛋白C受体与血管性血友病因子及可溶性血栓调节蛋白的水平变化[J].中华检验医学杂志,2016,39(10):783-785.
[11]陈孝红,王卓,马婷,等. v WF预测H型高血压患者血栓前状态的意义[J].昆明医科大学学报,2017,38(5):74-77.
[12]Landolt-Marticorena C,Prokopec SD,Morrison S,et al. A discrete cluster of urinary biomarkers discriminates between active systemic lupus erythematosus patients with and without glomerulonephritis[J]. Arthritis Research&Therapy,2016,18(1):218-229.
[13]叶梓,王世杰,李辉,等.血管内皮细胞中的凝血物质:理论研究新进展[J].中国组织工程研究,2017,21(4):627-632.
[14]贾贤达,杨庆华,茹建平. H型高血压患者血浆炎性因子及血流动力学的变化[J].宁夏医科大学学报,2017,39(2):230-232.
[15]Pang H,Han B,Fu Q,et al. Association of high homocysteine levels with the risk stratification in hypertensive patients at risk of stroke[J].Clin Ther,2016,38(5):1184-1192.
[16]张勇. H型高血压患者血管内皮功能变化及与血浆同型半胱氨酸水平的关系[J].河北医药,2017,39(17):2593-2596.
[17]Psaila B,Barkas N,Iskander D,et al. Single-cell profiling of human megakaryocyte-erythroid progenitors identifies distinct megakaryocyte and erythroid differentiation pathways[J]. Genome Biology,2016,17(1):83-101.