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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 investigate the changes and clinical significance of plasma hsCRP, vWF and vWF-cp in patients with renal damage induced by hypertension. Methods According to the 1999 WHO / ISH diagnostic criteria of hypertension and malignant hypertension, 28 patients with malignant hypertensive renal impairment and 40 patients with simple hypertension were enrolled. Select the same period 60 healthy subjects as a normal control. Automatic biochemical analyzer determination of blood glucose, blood lipids and other indicators. Immune turbidimetric assay hsCRP content. The level of vWF-cp in plasma was determined by enzyme-linked immunosorbent assay (ELISA) assay of plasma vWF concentration and residual collagen binding. Simultaneous determination of vWF-cp antibody levels. Results The plasma levels of vWF and hsCRP in hypertensive patients were significantly higher than those in normal control group (all P <0.01). The levels of vWF and hsCRP in patients with hypertension were significantly higher than those in patients with hypertension (vWF 142.4 ± 36.5% vs 118.6 ± 36.4%, hsCRP 10.20 ± 2.80 vs 2.46 ± 0.56 mg / 0.01]. Plasma vWF-cp activity in both hypertensive and malignant hypertensive renal impairment groups was significantly lower than that in the normal control group [(96.1 ± 25.7)% vs (86.9 ± 28.0)% vs (105.3 ± 15.7)%, P < 0.01]. There was no significant difference in the vWF-cp activity between malignant and hypertensive subjects (P> 0.05). No vWF-cp antibody was detected in all patients. Pearson correlation analysis showed that vWF was positively correlated with age, pulse pressure and hypertension risk stratification; vWF-cp was weakly positively correlated with age and hypertension risk stratification. Conclusion The plasma levels of hsCRP and vWF in hypertensive patients are elevated, and the patients with malignant hypertensive renal damage are more obviously elevated. Plasma vWF-cp activity in both hypertensive group and malignant hypertensive renal impairment group was significantly lower than that in normal control group. VWF-cp activity in patients with hypertension has nothing to do with the enzyme antibody.