高血压患者中血浆醛固酮水平与左心室结构的相关性  

Correlation between plasma aldosterone concentration and left ventricular structure in hypertensive patients

作　　者：张玉杰[1] 李南方[1] 张菊红[1] 邢卫红[1] 李变[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：《中华心血管病杂志》2013年第7期583-586,共4页Chinese Journal of Cardiology

基　　金：基金项目：新疆维吾尔自治区科技成果转化专项资金项目（201154126）

摘　　要：目的研究血浆醛固酮水平与左心室结构的关系，探讨左心室结构改变的病理生理机制。方法选取在新疆维吾尔自治区人民医院住院的高血压患者201例，男117例，女84例，年龄17～68岁，平均（43．64-10．2）岁。行心脏彩超检查和三体位血浆醛固酮浓度测定，根据坐位血浆醛固酮水平将研究对象分为醛固酮增高组（≥120ng／L）83例和醛固酮正常组（〈120ng／L）118例，分析两组间左心室结构的左心室舒张末期内径（LVEDD）、左心室后壁厚度（LVPWT）、室间隔厚度（IVST）、左心室质量指数（LVMI）等参数差异有无统计学意义；用简单相关和多元线性回归分析左心室结构相关参数与醛固酮的相关性。结果醛固酮增高组的舒张末期IVST、LVPWT大于醛固酮正常组[（10．4±1．0）mm比（10．9±1．8）mm，（10．1±0．7）mm比（10．4±1．5）mm，P〈0．05]，Spearman简单相关分析显示血浆醛固酮与舒张末期IVST相关（r=0．190，P〈0．05），而与舒张末期LVEDD、LVPWT、LVMI不相关（P〉0．05）。多元线性逐步回归分析显示血浆醛固酮与舒张末期IVST、LVPwr正相关（分别β=0．206，0．241，均P〈0．05），与LVEDD、LVMI不相关（P〉0．05）。结论在高血压患者中，血浆醛固酮水平与IVST、LVPWT呈正相关。Objective To observe the correlation between plasma aldosterone concentration （PAC） and left ventricular structure in hypertensive patients. Methods A total of 201 hypertensive patients [ 117 male, aged from seventeen to sixty eight years old, mean （43.6 ± 10. 2） years] were included. All subjects underwent echocardiography examination for measurement of left ventricular end-diastolic dimension （LVEDD）, LV posterior wall thickness （LVPWT）, interventricular septum thickness （IVST） and LV mass index （LVMI）. Plasma PAC was also measured at three postural positions. According to the sitting PAC, subjects were divided into high aldosterone group （PAC ≥120 mg/L, n = 83） and normal aldosterone （PAC 〈 120 mg/L, n = 118） group. Bivariate correlation and multiple stepwise regression analysis were performed to analyze the correlation between left ventricular structure parameters and PAC. Results IVST, LVPWT values were significantly higher in the increased PAC group than that in normal PAC group [ （ 10.4 ± 1.0） mm vs. （ 10. 9 ± 1.8 ） mm, （ 10. 1 ± 0. 7 ） mm vs. （ 10. 4 ±1.5 ） ram, all P 〈 0. 05 ]. Bivariate correlation analysis showed that PAC was weakly correlated with IVST （r =0. 190 ,P 〈0. 05 ）, while was not correlated to LVMI, LVPWT and LVEDD （ all P 〉 0.05 ）. Multiple linear stepwise regression analysis showed that PAC was positively correlated with IVST and LVPWT （fl = 0. 206 and fl = 0. 241, respectively, all P 〈 0. 05）, but was not correlated to LVMI and LVEDD （ all P 〉 0. 05 ）. Conclusion PAC is positively correlated with IVST and LVPWT in hypertensive patients.

关 键 词：高血压 醛固酮 肥大 左心室 

分 类 号：R544.1[医药卫生—心血管疾病]