高血压矿工血浆肾素、血管紧张素Ⅱ、醛固酮和皮质醇水平的分析  

A study on levels of plasma renin,angiotensinⅡ,aldosterone and cortisol in coal miners with hypertension

作　　者：梅仁彪[1] 

机构地区：[1]安徽理工大学医学院生理病生教研室,安徽淮南232001

出　　处：《中国工业医学杂志》2004年第4期220-223,共4页Chinese Journal of Industrial Medicine

基　　金：煤炭部青年科学基金资助项目 (97- 0 81 ) ;安徽省教育厅自然科学基金资助项目 (2 0 0 2kj2 82 )

摘　　要：目的　对煤矿工人血浆肾素活性 (PRA)、血管紧张素Ⅱ (AngⅡ )、醛固酮 (ALD)和皮质醇 (CORT)水平进行分析 ,探讨矿工高血压发病的因素和机制。方法　对地面与井下作业的煤矿工人进行问卷调查和血压、身高、体重的测量 ,用放射免疫测定法测定研究对象的血浆PRA、AngⅡ、ALD和CORT水平。结果　高血压组血浆PRA、AngⅡ和ALD水平显著高于非高血压组 (均P <0 0 1) ,矿工平均动脉血压与血浆PRA、AngⅡ和ALD水平呈显著正相关 (r =0 3 71、r =0 412和r =0 3 5 2 )。在高血压患者中 ,井下作业组血浆PRA、AngⅡ、ALD和CORT水平显著高于地面作业组 (均P <0 0 1) ,且井下作业组中又以安装维修组最高 ,CORT与AngⅡ水平呈显著正相关 (r =0 5 89) ;高盐饮食组血浆PRA、AngⅡ和ALD水平显著高于正常饮食组 (均P <0 0 1) ,而年龄、工龄、家族史、体重指数、吸烟和饮酒等因素对高血压患者血浆PRA、AngⅡ和ALD水平均无显著性影响。结论　煤矿井下作业可能作为一种应激刺激 ,在高盐饮食协同作用下 ,通过肾素 血管紧张素 醛固酮系统介导引发矿工高血压的发病。Objective To study plasma activity of renin(PRA),levels of angiotensinⅡ(AngⅡ),aldosterone(ALD)and corti-sol(CORT)in coal miners to explore the factors influencing pathogenesis of hypertension.Method A questionnaire study was conduct-ed in the coal miners with or without hypertension,their blood pressure,height and weight were measured,and PRA,AngⅡ,ALD and CORTwere determined by radioimmunoassay.Result Plasma activity of PRA and levels of AngⅡand ALDwere significantly higher in the hypertensive group than in the normotensive one(P<0.01),and average blood pressure positively correlated with activity of PRA and levels of AngⅡand ALD in all miners(r=0.371,r=0.412and r=0.352).Plasma activity of PRA and levels of AngⅡ,ALD and CORTwere significantly higher in the hypertensive miners operated underpit than in those of ground operation(P<0.01),with the highest in those doing installation-repair work underpit.And,level of CORT positively correlated with that of AngⅡ(r=0.589).Plasma activity of PRA,and levels of AngⅡand ALD were significantly higher in the miners with high-salt diet than in those with normal-diet(P<0.01),but no significant effects of age,length of employment,family history of hypertension,body mass index,smoking and alcohol drinking on plasma activity of PRA and levels of AngⅡand ALD were found.Conclusion Underpit opera-tion in coal mines might be a stress stimulus to cause their hypertension in coal miners with pathogenesis mediated by renin-angiotensin-aldosterone system and high-salt diet synergistically.

关 键 词：高血压 血管紧张素Ⅱ 皮质醇 应激 煤矿工人 

分 类 号：R544.1[医药卫生—心血管疾病] R335[医药卫生—内科学]