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血小板特异性蛋白及其他因素与高血压各阶段动脉粥样硬化的关系。

Relationship of platelet specific proteins and other factors to atherosclerosis in various stages of hypertension.

作者信息

Ding Y A, Chou T C, Huan R, Lin K C

机构信息

Department of Medicine, Tri-Service General Hospital.

出版信息

Clin Exp Hypertens A. 1991;13(8):1329-41. doi: 10.3109/10641969109048796.

Abstract

There is considerable evidence from previous studies that platelets play an important role in the development and progression of atherosclerosis in hypertension, more so in relation to the stage of hypertension. Seventy one hypertensive patients (WHO stage I: 39, stage II: 23, stage III: 9) aged 19-84 (mean age: 56, 59 and 62 respectively for each stage) and 37 normal controls (aged 22-72 with a mean age of 52) were involved in this study. Hematocrit, beta-thromboglobulin (beta-TG), platelet factor 4 (PF4), beta-TG/PF4 ratio, total cholesterol (TC), low density lipoprotein-C, and triglycerides were higher in the hypertensive group while platelet count, circulating platelet aggregates, and high density lipoprotein-C were higher in the normotensive group. Among the hypertensives, stage III patients showed the highest beta-TG, PF4, beta-TG/PF4 ratio, triglycerides, and stage I with the least elevation. There were no significant differences noted in the ADP or epinephrine-induced platelet aggregation in both the normal and hypertensive patients. Other parameters such as heart rate, serum sodium, potassium, renal and liver function tests, plasma renin activity, aldosterone, fibrinogen thromboxane B2 and 6-Keto-PGF1 alpha, showed no significant differences in both groups. This study clearly showed that beta-TG/PF4 ratio and triglycerides are closely related to the stage of hypertension and are good indicators of in vivo platelet activation in hypertensives which may account for the acceleration of hypertensive vascular complications secondary to atherogenesis.

摘要

以往研究有大量证据表明,血小板在高血压患者动脉粥样硬化的发生和发展过程中发挥重要作用,在高血压不同阶段作用程度有所不同。本研究纳入了71例年龄在19 - 84岁之间的高血压患者(世界卫生组织I期:39例,II期:23例,III期:9例,各期平均年龄分别为56岁、59岁和62岁)以及37例正常对照者(年龄在22 - 72岁之间,平均年龄52岁)。高血压组的血细胞比容、β-血小板球蛋白(β-TG)、血小板第4因子(PF4)、β-TG/PF4比值、总胆固醇(TC)、低密度脂蛋白-C和甘油三酯水平较高,而正常血压组的血小板计数、循环血小板聚集体和高密度脂蛋白-C水平较高。在高血压患者中,III期患者的β-TG、PF4、β-TG/PF4比值和甘油三酯水平最高,I期患者升高程度最小。正常人和高血压患者在二磷酸腺苷(ADP)或肾上腺素诱导的血小板聚集方面均未观察到显著差异。其他参数,如心率、血清钠、钾、肾和肝功能检查、血浆肾素活性、醛固酮、纤维蛋白原、血栓素B2和6-酮-前列腺素F1α,两组之间均无显著差异。本研究清楚地表明,β-TG/PF4比值和甘油三酯与高血压阶段密切相关,是高血压患者体内血小板活化的良好指标,这可能是动脉粥样硬化继发高血压血管并发症加速的原因。

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