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目的观察高血压病患者P-选择素水平变化,探讨其在高血压病发生冠心病事件中的作用。方法研究病例分为单纯高血压病组、高血压病合并冠心病组(CAD组),并设正常对照组。采用ELISA方法测定血浆P-选择素及高敏C反应蛋白水平。结果单纯高血压病患者与高血压病合并CAD患者血浆P-选择素浓度分别为(26.21±4.92)ng/ml,(31.05±5.78)ng/ml,明显高于正常对照组(16.54±3.32)ng/ml,差异有显著性(P<0.05)。但是,单纯高血压病组与高血压病合并CAD组血浆P-选择素水平无显著差异(P>0.05),单纯高血压组血浆P-选择素水平在治疗2个月后下降(21.76±4.19)ng/ml,与治疗前差异有显著性。合并CAD的高血压病患者中cTnI均数为(0.18±0.06)ng/ml。相关分析显示,CAD组血浆P-选择素水平与cTnI水平Pearson相关系数为0.492,二者呈正相关(P=0.001)。单纯高血压病患者与高血压病合并CAD患者血浆hsCRP分别为(3.85±0.47)ng/ml,(5.52±0.56)ng/ml,均高于对照组(1.77±0.35)ng/ml,且合并CAD的患者hsCRP的水平要高于单纯高血压组。结论高血压病患者体内存在血小板的活化,血浆P-选择素持续处于较高的水平是高血压病发生CAD的危险因素。
Objective To observe the changes of P-selectin in patients with essential hypertension, and to explore its role in the occurrence of coronary heart disease in patients with hypertension. Methods Study cases were divided into simple hypertension group, hypertension complicated with coronary heart disease group (CAD group) and normal control group. Plasma P-selectin and high-sensitivity C-reactive protein levels were measured by ELISA. Results The plasma concentrations of P-selectin in hypertensive patients with hypertension and CAD patients were (26.21 ± 4.92) ng / ml and (31.05 ± 5.78) ng / ml, respectively, which were significantly higher than those in the normal controls (16.54 ± 3.32) ng / ml, the difference was significant (P <0.05). However, plasma P-selectin levels were not significantly different between hypertensive patients and hypertensive patients with CAD (P> 0.05). The plasma P-selectin levels in hypertensive patients were decreased after 2 months (21.76 ± 4.19 ) ng / ml, with the difference before treatment was significant. The mean cTnI in hypertensive patients with CAD was (0.18 ± 0.06) ng / ml. Correlation analysis showed that Pearson correlation coefficient between plasma P-selectin level and cTnI level in CAD group was 0.492 (P = 0.001). The plasma levels of hsCRP were (3.85 ± 0.47) ng / ml and (5.52 ± 0.56) ng / ml in patients with hypertension and CAD with hypertension respectively, which were significantly higher than those in the control group (1.77 ± 0.35) ng / ml Patients with CAD have higher hsCRP levels than those with hypertension alone. Conclusion Platelet activation exists in the hypertensive patients, and plasma P-selectin level continues to be a high risk factor for CAD in hypertension.