高血压患者晨间血压升高的病因探讨  

Cause of morning surge hypertension

作　　者：朱艳利[1] 王秀莉 朱学梅[1] 卓晶明[1] 李文华[1] 

机构地区：[1]山东大学附属省立医院老年心血管科,济南250021 [2]枣庄矿业集团东郊医院,山东枣庄277110

出　　处：《山东大学学报（医学版）》2011年第7期113-116,共4页Journal of Shandong University:Health Sciences

基　　金：山东省卫生厅科研基金资助项目(2005-3)

摘　　要：目的寻找引起晨间血压升高的危险因素。方法将高血压患者分为晨峰组和非晨峰组,检测血液中血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、生长激素(GH)、皮质醇(COR)水平。分析晨峰睡-谷值与AngⅡ、ALD、GH、COR的相关性。结果老年原发性高血压患者主要为低肾素型高血压。晨峰组与非晨峰组在性别、年龄、体质量指数(BMI)、血脂和高血压病程方面无显著性差异。晨峰组的AngⅡ、ALD均高于非晨峰组(P<0.05),血GH和COR也均显著增高(P<0.01)。相关分析结果显示,晨峰组的晨峰睡-谷值与AngⅡ(r=0.42,P<0.01)、ALD(r=0.28,P<0.05)、GH(r=0.45,P<0.01)、COR(r=0.32,P<0.01)均呈现正相关。结论晨间血压升高与肾素血管紧张素系统激活密切相关,也与血液中生长激素、皮质醇浓度过高有密切关系。Objective To investigate risk factors for morning surge in hypertension.Methods 201 cases were divided into the morning surge group and the non-morning group.The levels of plasma rennin activity（PRA）,angiotensin II（AngⅡ）,aldosterone（ALD）,growth hormone（GH） and cortisol（COR） were detected.The correlation between sleep-trough morning surge variability and levels of AngⅡ,ALD,GH and COR were analyzed.Results AngⅡ and ALD levels in the morning surge group are higher than those in the non-morning group（P〈0.05）,GH and COR levels were also higher（P〈0.01）.Sleep-trough morning surge had positive correlations with levels of AngⅡ（r=0.42,P〈0.01）,ALD（r=0.28,P〈0.05）,GH（r=0.45,P〈0.001） and COR（r=0.32,P〈0.01）.Conclusion Morning surge hypertension is closely related to activation of the renin-angiotension system and levels of GH and COR.

关 键 词：高血压 晨峰 血管紧张素Ⅱ 生长激素 氢化可的松 

分 类 号：R544.1[医药卫生—心血管疾病]