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目的观察不同危险度分层的老年高血压患者血清中抗心磷脂抗体(ACLA)的结合指数(BI)的变化,了解ACLA在高血压发生发展中的临床意义及缬沙坦对老年高血压患者血管内皮功能的影响。方法采用酶联免疫吸附法检测2004年1月至2007年1月在南昌大学第一附属医院干部病房住院及门诊就诊的年龄≥60岁的120例高血压患者和30名健康者以及20名年龄<60岁健康者ACLA的BI,对不同危险度分层的老年高血压患者ACLA的BI进行比较。对患病组60例患者予以缬沙坦80~160mg/d干预治疗6周,观察缬沙坦对高血压患者ACLA的疗效。结果老年高血压中危、高危、极高危组ACLA的BI与健康组、低危组比较明显升高,差异有显著性意义(P<0.05,P<0.01),低危组与健康对照组ACLA的BI比较,差异无显著性意义(P>0.05),年龄≥75岁与年龄<75岁的两组健康者ACLA的BI比较,差异有显著性意义(P<0.05)。经缬沙坦80~160mg/d治疗6周后,各组患者血压降至正常范围,其中老年高血压中危、高危、极高危组ACLA的BI较治疗前降低,差异有显著性意义(P<0.05,P<0.01),且危险程度越高,ACLA的BI下降越显著。结论高血压患者可能存在自身免疫,ACLA的测定对预测高血压病情轻重及并发症的发生有一定的临床意义。缬沙坦降压疗效显著,能改善高血压引起的内皮功能损害。
Objective To observe the change of the binding index (BI) of serum anticardiolipin antibody (ACLA) in elderly patients with different risk stratification to understand the clinical significance of ACLA in the development of hypertension and the effect of valsartan on elderly hypertensive patients The effects of vascular endothelial function. Methods Enzyme-linked immunosorbent assay was used to detect 120 hypertensive patients and 30 healthy people aged 60 and over who were hospitalized and out-patient in cadre wards of the First Affiliated Hospital of Nanchang University from January 2004 to January 2007 and 20 healthy subjects BIAs of ACLA in <60-year-old healthy individuals were compared for BIAs of ACLA in elderly hypertensive patients with different risk stratifications. Sixty patients in the diseased group were treated with valsartan 80 ~ 160mg / d for 6 weeks, and the effect of valsartan on ACLA in hypertensive patients was observed. Results Compared with healthy group and low-risk group, the ACLA BI in middle-risk, high-risk and very high-risk group of senile hypertension significantly increased (P <0.05, P <0.01) (P> 0.05). There was significant difference (P <0.05) in the BI of ACLA between two groups of healthy people aged 75 and 75 years old. Valsartan 80 ~ 160mg / d for 6 weeks after treatment, the blood pressure in each group fell to the normal range, including hypertension in high risk, high risk, very high risk group ACLA BI decreased compared with before treatment, the difference was statistically significant (P <0.05, P <0.01), and the higher the degree of risk, the more significant the decline of BI in ACLA. Conclusion There may be autoimmunity in patients with hypertension. The determination of ACLA has some clinical significance in predicting the severity of hypertension and the incidence of complications. Valsartan antihypertensive effect is significant, can improve endothelial dysfunction caused by hypertension.