Study On The Changes Of Endothelial Cell Disturbance, Blood Coagulation And Fibrinolysis Indexes In Geriatric Essential Hypertension Patient

Objective To study the clinical significance of the changes of endothelial cell disturbance, blood coagulation and fibrinolysis indexes in geriatric patients with simplex essential hypertension (EH), and incorporative acute coronary syndrome (ACS), stable angina pectoris (SAP) and diabetes mellitus (DM).Methods The studied cases amount to 139 including 114 cases in senile EH group and 25 cases in healthy contrast group.According to the criterion whether the patient suffered from complication, the 114 cases of senile EH group were divided into four subgroups: EHA subgroup (simplex EH) with 54 cases; EHB subgroup ( EH incorporative ACS) with 14 cases; EHC subgroup (EH incorporative SAP) with 26 cases and EHD subgroup (EH incorporative DM) with 20 cases.Von willebrand factor (VWF), D-dimer(DD), antithrombin III (AT-III), platelet (PLT), plasma prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (FIB) were measured for all subgroups. And comparison was made for all the above parmeters between the senile EH subgroups.Results 1. No significant difference was found in PLT, PT, APTT, TT and FIB level between senile EHA, B, C, D subgroups and contrast group (P>0.05); 2. Compared with the contrast group, the concentration of VWF and D-dimer was found to be significantly higher, and the concentration of AT-III significantly lower (P<0.05) in the senile simplex EH group. 3. Compared with contrast group, senile simplex EH subgroup and senile EH incorporative SAP subgroup, the patients of senile EH incorporative ACS subgroup had higher VWF and DD and lowerAT-â…¢ levels (P<0.05), There was no significant difference between senile EH incorporative SAP subgroup and senile simplex EH subgroup (P>0,05), but there was distinct difference between senile EH incorporative SAP subgroup and contrast group (P<0.05); 4. Compared with contrast group and senile simplex EH subgroup, the concentration of VWF and DD significantly increased (P<0.05) while the level of AT-â…¢ significantly decreased (P<0.05) for the senile EH incorporative DM subgroup.Conclusions 1. Routine blood indexes such as PT, APTT, TT and FIB are not sensitive for examining blood coagulation state in geriatric essential hypertension;2. There are endothelial cell disturbance, increase of coagulability in senile essential hypertension, specially in hypertension patients with ACS and DM. The VWF, DD and AT-â…¢ prethrombotic state indexes of senile hypertension patient provide reliable references for clinical hypertension treatment, improvement endothelial cell function and anti-blood-coagulation therapy.