Serum lipidleri normal ve yüksek olan hipertansif hastalarda fibrinolitik aktivite

Fibrinolytic activity in hypertensive patients who have normal and high serum lipid levels

Özet

Amaç: Hipertansif kardiyovasküler hastalarda fibrinolitik aktivite düşüklüğü ve biperlipidemi önemli risk faktörleridir. Bu çalışmada hipertansiyonlu hastalarda serum lipidleri ile fibrinolitik aktivite arasındaki ilişkiyi inceledik, Yöntem: Çalışmaya serum lipidleri normal (yaş ortalaması 5332) ve serum lipidleri yüksek (yaş ortalaması 47.2) olan 25'er hipertansif hasta grubu alındı. Kontrol grubu olarak da yaş ortalaması 46.2, serum lipidleri normal, tansiyonu normal sınırlarda olan 15 sağlıklı birey alındı. Hastalardan bazal düzeyde açlık kanı alınarak serum lipidleri, 1/9 oranında sitratlı kan numuneleri alınarak da euglobulin erime zamanı (EEZ), fibrin plak yöntemleriyle fibrinolitik aktivite (FA)'leri ve fibrinojen değerleri tayin edildi. Bulgular: Fibrin plak metodunda, kontrol grubuna göre serum lipidleri normal olan hipertansif grupta FA %35.60 düşük (p< 0.001), serum lipidleri yüksek olan hipertansif grupta ise %59.70 daha düşük idi (p< 0.001). EEZ metodunda, kontrol grubuna göre FA serum lipidleri normal olan hipertansif grupta %55.53 düşük, serum lipidleri yüksek olan hipertansif grupta ise %78.01 daha düşük idi (p< 0.001). Fibrinojen değerleri de kontrol grubuna göre her iki hipertansif grupta da anlamlı olarak yüksek idi (p< 0.001). Yorum: Serum lipidleri yüksek olan hipertansif grupta FA daha düşük olmakla beraber serum lipidleri normal olan hipertansif grupta da anlamlı olarak düşük bulunmuştur. Bu da hipertansif hastalarda FA düşüklüğünün lipidlerden bağımsız olduğunu düşündürmektedir.

Abstract

Objective: Impairment of fibrinolysis and hyperlipidemia are important risk factors in hypertensive cardiovascular disease. We examined the relations of serum lipid levels and fibrinolytic activity (FA) in hypertensive patients. Method: In this study 25 hypertensive patients aged mean 5332 with serum lipids are normal and 25 hypertensif patients aged mean 47.2 with serum lipids are high were included. As control group normotensive subjects aged mean 46.2 whose serum lipids are normal were studied. The blood samples were drawn in the morning after an overnight fast. Samples were drawn after at least 10 min of rest in the recumbent position, with a minimum of stasis by means of an injector containing 1/9 volume of sodium citrate. Plasma samples were used for fibrinolysis test. Serum samples were used for analysis oflipids. FA by euglobulin lysis time (ELT), fibrin plate methods and the plasma fibrinogen levels were determined.Results: In fibrin plate method, according to the control group in the hypertensive group with normal serum lipid levels the FA 35.60% was reduced (p< 0.001) while in hypertensive group with serum lipid levels high was 59.70% reduced (p< 0.001). In ELT, according to the control group, in hypertensive group with serum lipid levels normal, FA was 55.53% reduced while in hypertensive group with serum lipid levels high was 78.01% reduced (p< 0.001). Fibrinogen levels in both hypertensive groups were significantly increased than control group (p< 0.001). Conclusion: Hypertensive patients with normal serum lipid have a reduced activity of the fibrinolytic system like hypertensive patients with high serum lipids. These results suggest that reduced FA in hypertensive patients is indepentfrom serum lipids.