Verhaar M C, Beutler J J, Gaillard C A, Koomans H A, Fijnheer R, Rabelink T J
Department of Nephrology & Hypertension, University of Utrecht, The Netherlands.
J Hypertens. 1998 Jan;16(1):45-50. doi: 10.1097/00004872-199816010-00008.
To assess whether increased shedding of adhesion molecules in plasma provides an index for endothelial damage in hypertension.
Three groups of hypertensive patients with increasing severity of vascular damage were studied: 20 essential hypertensives, 21 atherosclerotic, renovascular hypertensives and four malignant hypertensives. Twenty healthy subjects were included as a control group. Levels of P-selectin, E-selectin, intracellular adhesion molecule 1, vascular cell adhesion molecule and von Willebrand factor in venous blood were measured, using sandwich-type enzyme-linked immunosorbent assay.
For essential hypertensives a trend for increased P-selectin and E-selectin values compared with those in controls was observed (159+/-44 versus 132+/-40 ng/ml, P = 0.062 and 40+/-13 versus 34+/-17 ng/ml, P = 0.055, respectively). P-selectin (210+/-84 ng/ml, P = 0.0021) and E-selectin (42+/-12 ng/ml, P = 0.012) levels in renovascular hypertensives were significantly higher than those in healthy controls. There were no significant increases in circulating levels of intracellular adhesion molecule 1, vascular cell adhesion molecule and von Willebrand factor either in essential hypertensives or in renovascular hypertensives. Marked increases in circulating levels of adhesion molecules and von Willebrand factor relative to those in controls were observed in malignant hypertensives (P-selectin 634+/-332 versus 132+/-40 ng/ml, P = 0.0004; vascular cell adhesion molecule 968+/-187 versus 493+/-139 ng/ml, P = 0.0004; and von Willebrand factor 259+/-75 versus 130+/-72 U/dl, P = 0.016).
Progression of vascular damage in essential, renovascular and malignant hypertension is associated with a rise in circulating levels of P-selectins and, to a lesser extent, E-selectins, whereas levels of intracellular adhesion molecule 1, vascular cell adhesion molecule and von Willebrand factor are elevated only in diseases associated with acute severe vascular damage, including malignant hypertension. Our data suggest that selectins may be useful as indicators of vascular damage in hypertension.
评估血浆中黏附分子水平升高是否可作为高血压患者内皮损伤的指标。
研究了三组血管损伤程度逐渐加重的高血压患者：20例原发性高血压患者、21例动脉粥样硬化性肾血管性高血压患者和4例恶性高血压患者。纳入20名健康受试者作为对照组。采用夹心型酶联免疫吸附测定法检测静脉血中P选择素、E选择素、细胞间黏附分子1、血管细胞黏附分子和血管性血友病因子的水平。
与对照组相比，原发性高血压患者的P选择素和E选择素水平有升高趋势（分别为159±44对132±40 ng/ml，P = 0.062；40±13对34±17 ng/ml，P = 0.055）。肾血管性高血压患者的P选择素（210±84 ng/ml，P = 0.0021）和E选择素（42±12 ng/ml，P = 0.012）水平显著高于健康对照组。原发性高血压患者和肾血管性高血压患者的细胞间黏附分子1、血管细胞黏附分子和血管性血友病因子的循环水平均无显著升高。恶性高血压患者的黏附分子和血管性血友病因子的循环水平相对于对照组显著升高（P选择素634±332对132±40 ng/ml，P = 0.0004；血管细胞黏附分子968±187对493±139 ng/ml，P = 0.0004；血管性血友病因子259±75对130±72 U/dl，P = 0.016）。
原发性、肾血管性和恶性高血压患者血管损伤的进展与循环中P选择素水平升高有关，E选择素水平升高程度较轻，而细胞间黏附分子1、血管细胞黏附分子和血管性血友病因子水平仅在包括恶性高血压在内的急性严重血管损伤相关疾病中升高。我们的数据表明，选择素可能作为高血压患者血管损伤的指标。
