【摘要】 目的探讨恶性高血压肾损害患者血浆高敏C反应蛋白(hsCRP)、血管性血友病因子(vWF)、血管性血友病因子裂解酶(vWF-cp)的变化及意义。方法根据1999年世界卫生组织/国际高血压学会(WHO/ISH)高血压及恶性高血压诊断标准入选恶性高血压肾损害患者28例,单纯高血压患者40例。选择同期健康体检者60例作为正常对照。全自动生化分析仪测定血糖、血脂等指标。免疫比浊法测定hsCRP含量。酶联免疫吸附试验(ELISA)测定血浆vWF浓度,残余胶原结合力试验测定血浆vWF-cp活性水平。同时测定vWF-cp抗体水平。结果高血压患者血浆vWF、hsCRP水平均高于正常对照组(均P<0.01)。恶性高血压组vWF及hsCRP水平均高于单纯高血压组[vWF(142.4±36.5)%比(118.6±36.4)%;hsCRP(10.20±2.80)比(2.46±0.56)mg/L;均P<0.01]。单纯高血压组与恶性高血压肾损害组血浆vWF-cp活性均明显低于正常对照组[分别为(96.1±25.7)%,(86.9±28.0)%比(105.3±15.7)%;均P<0.01]。恶性高血压与单纯高血压组vWF-cp活性无明显差异(P>0.05)。所有患者均未检测到vWF-cp抗体。Pearson相关分析表明,vWF与年龄、脉压和高血压危险度分层呈正相关;vWF-cp与年龄、高血压危险度分层呈弱正相关。结论高血压患者血浆hsCRP、vWF水平升高,恶性高血压肾损害患者升高更明显。单纯高血压组与恶性高血压肾损害组血浆vWF-cp活性均明显低于正常对照组。高血压患者vWF-cp活性下降与该酶抗体无关。更多还原

【Abstract】 Objective To evaluate the changes and significance of plasma high sensitivity C-reactive protein(hs-CRP),von Willebrand factor(vWF),von Willebrand factor-cleaving protease(vWF-cp)activity in patients with malignant hypertension presenting with renal damage.Methods Twenty-eight patients with malignant hypertension presenting with renal damage and 40 patients with essential hypertension(EH)were selected according to the 1999 WHO/ISH diagnostic code of hypertension and malignant hypertension.Automatic biochemistry analyzer was used to detect the levels of plasma creatinine,glucagon,cholesterol and triacylglycerol concentration.hs-CRP was detected by immunonephelometry.Enzyme linked immunosorbent assay(ELISA)and residual-collagen binding assay(R-CBA)were used to respectively detect the vWF,vWF-cp activity and their antibodies.All results were compared with 60 normal controls.Results Levels of plasma hs-CRP and vWF in patients with hypertension were higher than those in normal control group and lower than those in patients with malignant hypertension [vWF:malignant hypertension(142.4±36.5)% vs hypertension(118.6±36.4)%;hsCRP:malignant hypertension(10.20±2.80)vs hypertension(2.46±0.56)mg/L;both P<0.01].Compared with normal controls,plasma vWF-cp activity in both patients with malignant hypertension presenting with renal damage and patients only with EH were significantly decreased [(96.1±25.7)%,(86.9±28.0)% vs(105.3±15.7)%;both P<0.01].There was no difference between patients with malignant hypertension and patients with EH in the level of plasma vWF-cp activity(P>0.05).Antibody was not detected in all these patients.Pearson correlation analysis showed that vWF was positively correlated with age,pulse pressure and hypertension risk stratification;vWF-cp was positively correlated with hypertension risk stratification and age.Conclusion Levels of plasma hs-CRP,vWF were increased in patients with hypertension,especially in patients with malignant hypertension who presenting with renal damage.The activity of vWF-cp in patients with malignant hypertension who presenting with renal damage and patients with essential hypertension were decreased significantly compared to the normal control.There was no relationship between the decreased activity of vWF-cp and the antibody of this enzyme in patients with hypertension.更多还原