Nomura S, Kanazawa S, Fukuhara S
First Department of Internal Medicine, Kansai Medical University, Moriguchi, Osaka, Japan.
J Hum Hypertens. 2002 Aug;16(8):539-47. doi: 10.1038/sj.jhh.1001447.
We compared the levels of microparticles, platelet activation markers, soluble cell adhesion molecules, and soluble selectins between hypertensive patients with and without type 2 diabetes and control subjects. Binding of anti-glycoprotein IIb/IIIa and anti-glycoprotein Ib monoclonal antibodies to platelets did not differ significantly between the hypertensive patients and controls, but platelet expression of activation markers (CD62P, CD63, PAC-1, and annexin V) was higher in the hypertensive patients. Platelet-derived microparticle (PDMP) and monocyte-derived microparticle (MDMP) levels were significantly higher in the hypertensive patients than in the controls. Soluble ICAM-1, VCAM-1, P-selectin, and E-selectin levels were also higher in the hypertensive patients, and they were significantly higher in the hypertensive patients with diabetes. After treatment with efonidipine, the levels of PDMPs, CD62P-, CD63-, PAC-1-, and annexin V-positive platelets, sICAM-1, sVCAM-1, sP-selectin, and sE-selectin all decreased significantly. The MDMP levels decreased, and the decrease was significant in the hypertensive patients with diabetes. These findings suggest that administration of efonidipine to hypertension patients with diabetes may prevent the development of cardiovascular complications caused by cell adhesion molecules or activated platelets and monocytes.
我们比较了伴有和不伴有2型糖尿病的高血压患者与对照受试者之间的微粒、血小板活化标志物、可溶性细胞粘附分子和可溶性选择素水平。抗糖蛋白IIb/IIIa和抗糖蛋白Ib单克隆抗体与血小板的结合在高血压患者和对照之间无显著差异,但高血压患者中血小板活化标志物(CD62P、CD63、PAC-1和膜联蛋白V)的表达更高。高血压患者的血小板衍生微粒(PDMP)和单核细胞衍生微粒(MDMP)水平显著高于对照。可溶性ICAM-1、VCAM-1、P-选择素和E-选择素水平在高血压患者中也更高,且在伴有糖尿病的高血压患者中显著更高。用依福地平治疗后,PDMPs、CD62P、CD63、PAC-1和膜联蛋白V阳性血小板、sICAM-1、sVCAM-1、sP-选择素和sE-选择素水平均显著降低。MDMP水平降低,且在伴有糖尿病的高血压患者中降低显著。这些发现表明,对伴有糖尿病的高血压患者给予依福地平可能预防由细胞粘附分子或活化血小板及单核细胞引起的心血管并发症的发生。