睡眠呼吸暂停相关性高血压血清醛固酮及补体C1q-肿瘤坏死因子相关蛋白1的水平及其相关因素  

Relationship between aldosterone and complement c1q tumor necrosis factor-related protein 1 in sleep apnea-related hypertension

作　　者：程维平[1] 姚晓光[1] 严治涛[1] 毕云伟[1] 韩瑞梅[1] 李南方[1] 

机构地区：[1]新疆维吾尔自治区人民医院高血压中心新疆高血压研究所,乌鲁木齐830001

出　　处：《临床心血管病杂志》2012年第8期584-586,共3页Journal of Clinical Cardiology

基　　金：国家重点基础研究发展计划项目(973计划)(No:2012CB517802)

摘　　要：目的:探讨睡眠呼吸暂停相关性高血压血清醛固酮及补体C1q-肿瘤坏死因子相关蛋白1(CTRP1)的水平及其相关因素。方法:在高血压科住院患者中选取正常及低肾素的睡眠呼吸暂停相关性高血压患者26例(病例组),取同期住院的且性别、年龄及肾素活性(PRA)匹配的原发性高血压患者30例作为对照组,放射免疫法测定所有患者的血清醛固酮水平,酶联免疫吸附法检测CTRP1浓度。结果:病例组BMI(P<0.01)、醛固酮水平(P<0.05)、超敏C反应蛋白水平(P<0.01)均明显高于对照组。Pearson相关分析显示,醛固酮与BMI呈正相关(r=0.283,P=0.035),与CTRP1不相关(r=0.109,P=0.425);CTRP1与血钾呈负相关(r=-0.284,P=0.035)。多元逐步线性回归分析显示,PRA(β=0.351,P=0.008)及BMI(β=0.270,P=0.039)进入以醛固酮为应变量的方程,贡献为PRA>BMI,在控制PRA的影响后发现,BMI是醛固酮水平独立的影响因素;血钾进入以CTRP1为应变量的方程(β=-0.289,P=0.029)。结论:睡眠呼吸暂停相关性高血压患者中,BMI对醛固酮水平的影响可能独立于肾素-血管紧张素-醛固酮系统,且患者血清中CTRP1与血钾呈负相关。Objective：To investigate the relationship between aldosterone and complement c1q tumor necrosis factor-related protein 1（CTRP1） in sleep apnea-related hypertension（SA-RH）.Method：A total of 26 SA-RH subjects was recruited（case group）.Hypertensive patients with AHI less than 15 event/h and matched gender,age and PRA served as control group.Radio-immunoassay was performed to determine the components of rennin-angiotensin-aldosterone system（RAAS） hormone.The levels of serum CTRP1 were assessed by ELISA.Result：BMI was much higher in SA-RH group than that in control group（P〈0.01）,without significant difference in blood pressure and fasting blood glucose between the two groups.The levels of aldosterone and high sensitive C-reaction protein were much higher in SA-RH group than those in control group（P〈0.05）,without significant difference in PRA,angiotensin Ⅱ,CTRP1,serum potassium and serum sodium between the two groups.Pearson correlation analysis showed that plasma aldosterone level was positively correlated with BMI（r=0.283,P=0.035）,but uncorrelated with CTRP1（r=0.109,P=0.425）;while CTRP1 was negatively correlated with serum potassium（r=-0.284,P=0.035）.Multiple linear regression showed that BMI influenced the levels of aldosterone（β=0.270,P=0.039） independently of PRA（β=0.351,P=0.008）;while serum potassium was the only factor influencing CTRP1.Conclusion：In SA-RH patients,aldosterone is positively correlated with BMI independently of RAAS,and CTRP1 is negatively correlated with potassium.

关 键 词：高血压 睡眠呼吸暂停 补体C1q-肿瘤坏死因子相关蛋白1 醛固酮 

分 类 号：R544.1[医药卫生—心血管疾病]