肾动脉狭窄与低血钠-高血压综合征的临床分析  

Clinical analysis of 9 cases of hyponatremic hypertensive syndrome

作　　者：岳少姬[1] 赵娜[1] 郭珍[2] 张伟[1] 郎艳华[3] 邵乐平[1] 

机构地区：[1]青岛大学医学院附属医院肾内科,266003 [2]青岛大学医学院附属医院病案室,266003 [3]青岛大学医学院附属医院门诊部,266003

出　　处：《临床肾脏病杂志》2012年第12期549-552,共4页Journal Of Clinical Nephrology

基　　金：国家自然科学基金资助项目（81170653）,山东省科技厅基金资助项目（BS2010YY011）,青岛市科委基金资助项目（10-3-47-7-JCH）

摘　　要：目的收集和分析肾动脉狭窄与低血钠-高血压综合征患者的临床特点。方法回顾性分析2001～2（）11年我院住院治疗的肾动脉狭窄、低血钠-高血压综合征。结果9例患者符合低血钠-高血压综合征的入选标准。除2例患者外，均为规律吸烟患者。所有患者中，8例患者与肾动脉粥样硬化有关，1例患者与纤维肌性发育不良有关。血管紧张素II和血浆醛固酮水平明显升高，而且与患者的最低血钠浓度呈明显负相关（r=-0．90，P〈0．01；r=-0．81，P〈0．05）。结论低血钠-高血压综合征的主要病因是动脉粥样硬化导致的肾动脉狭窄。肾素-血管紧张素系统激活可能是低血钠-高血压综合征病理生理机制的核心。该病是肾动脉狭窄的少见并发症，但值得临床医生提高认识和进一步研究。Objective To collect and analyze the clinical characteristics of patients with hy- ponatremic hypertensive syndrome（HHS）. Methods Patients with HHS presenting between 2001 and 2011 in the affiliated hospital of Qingdao University School of Medicine were retrospectively analyzed. Results A total of 9 cases fulfilled the inclusion criteria of HHS. Among of them, six patients were male with a mean age 61 years and three were female of mean age 51 years. All were regular smokers except for 2 cases. As to the etiology, 8 cases were related with atherosclerosis, one was associated with fibromuscular dysplasia. Both plasma angiotensin II and aldosterone were elevated, and related inverse- ly to the lowest recorded plasma sodium level （r= - 0. 90,P（0. 01 ;r= - 0. 81 ,P（0. 05）. Conclusions HHS was commonly caused by atherosclerotic renal artery stenosis which may be closely related with smoking. Intense activation of the renin-angiotensin system might be the central to the pathophysiology of the HHS. The syndrome is a rare complication of renal artery stenosis,and deserves better recogni- tion and further investigations.

关 键 词：高血压 肾动脉梗阻 治疗 

分 类 号：R544.1[医药卫生—心血管疾病]