基线肾素-血管紧张素-醛固酮系统活性对服用氢氯噻嗪后血糖影响研究  

Effect of baseline activity of RAAS on blood glucose in hypertensive patients treated with hydrochlorothiazide.

作　　者：李云[1] 赵爽[1] 杨鹏[2] 刘星[3] 吴云涛[3] 武英[1] 赵丹丹[1] 刘秀荣[3] 吴寿岭[3] 

机构地区：[1]河北联合大学公共卫生学院,河北唐山063000 [2]河北联合大学附属医院,河北唐山063000 [3]河北联合大学附属开滦医院,河北唐山063000

出　　处：《中国实用内科杂志》2014年第1期58-61,共4页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金(81000110);河北省高校百名优秀创新人才支持计划;河北省高等学校科学技术研究优秀青年基金项目(YQ2013004)

摘　　要：目的探讨基线肾素-血管紧张素-醛固酮系统(RAAS)活性对服用氢氯噻嗪后血糖的影响。方法选择2002年6月至2003年6月开滦9所医院119例高血压患者,分别根据基线肾素活性、血管紧张素转换酶、血管紧张素Ⅱ和醛固酮将研究对象分为较高活性、较低活性两组,均给予氢氯噻嗪12.5 mg,每日1次,1年后分别比较两组患者RAAS活性变化和血糖变化情况。结果服用氢氯噻嗪1年后,基线AngⅡ较高者肾素活性[(0.95±0.24)μg/(L·h)对(-0.19±0.21)μg/(L·h)]、血管紧张素Ⅱ[(19.38±6.34)ng/L对(-0.79±3.47)ng/L]、醛固酮[(81.57±30.64)pmol/L对(-12.02±40.83)pmol/L]和血糖下降幅度[(1.13±0.27)mmol/L对(0.52±0.10)mmol/L]均高于基线AngⅡ较低者,差异有统计学意义。偏相关分析结果显示基线AngⅡ与服用氢氯噻嗪1年后血糖变化呈正相关关系(r=0.248,P=0.017)。结论基线AngⅡ与服用氢氯噻嗪1年后血糖变化呈正相关关系。Objective To explore the effect of baseline activity of renin-angiotensin- aldosterone system （RAAS） on blood glucose in hypertensive patients treated with hydrochlorothiazide, Methods A total of 119 hypertensive patients were re cruited in this study. All subjects were divided into a high-activity group or low activity group based on the baseline activity of RAAS. The activity of RAAS and gloeose level were compared between two groups after 1-year treatment of hydrochloroth iazide. Results After 1 year of hydrochlorothiazide treatment, the decreases of renin （ [ 0. 95 ± 0. 24 ] μg/[ L. h ] vs [ -0. 19 ±0. 21 ] p,g/[ L . h l ）, angiotensin ]I （ [19. 38 ± 6. 34 ] ng/L vs [ -0. 79 ± 3.47 ] ng/L）,aldosterone （ [81.57 ± 30. 64 ] pmol/L vs [ - 12.02± 40. 83 ] pmol/L）, and glucose （ [ 1.13 ±0. 27 mmol/L vs [ 0. 52 ± 0. 10 ] mmol/L） in pa tients with high levels of baseline angiotensin were higher than those in patients with low levels of baseline angiotensin U , and all differences were significant. The results of correlation analysis showed that there was a positive correlation between the baseline level of angiotensin and the decrease of glucose after 1 year of hydrochlorothiazide treatment （ r = 0. 248 ,P =0. 017）. Conclusion There is a positive correlation between the baseline level of angiotensin 11 and decrease of glucose after 1-year treatment of hydrochlorothiazide.

关 键 词：肾素-血管紧张素-醛固酮系统 氢氯噻嗪 血糖 高血压 

分 类 号：R587.1[医药卫生—内分泌]