苏北地区原发性醛固酮增多症流行病学研究  

Epidemiologic study of primary aldosteronism in northern Jiangsu

作　　者：祁建成[1] 居峰[1] 万镇[1] 范修才[1] 

机构地区：[1]南通大学附属建湖医院心内科,江苏南通224700

出　　处：《心血管康复医学杂志》2015年第3期264-267,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:采用血浆醛固酮/肾素活性比值(ARR)联合血浆醛固酮水平在高血压患者中筛查原发性醛固酮增多症(PA)患者,探讨苏北地区PA的流行病学特点。方法:收集我院门诊和住院的高血压患者2014例,用放射免疫方法测定血浆肾素和醛固酮水平及血生化指标,计算ARR。以ARR>240同时醛固酮>150pg/ml诊断为PA,分析其临床特点。结果:2014例高血压患者中,合并PA患者239例(11.87%),其在难治性高血压人群中占23.69%(145/612)。与单纯高血压组比较,PA组肾素活性[(2.18±2.54)ng·ml-1·h-1比(0.68±0.49)ng·ml-1·h-1]及血钾[(3.96±0.45)mmol/L比(3.54±0.45)mmol/L]水平明显降低,而醛固酮水平[(132.99±104.25)pg/ml比(272.55±154.68)pg/ml]及ARR[(118.40±109.4)比(463.19±251.85)]明显升高(P<0.05或<0.01);出现高血压更年轻[(49.37±9.31)岁比(39.69±7.59)岁](P<0.01)。PA合并低钾血症占33.47%,直线相关分析显示,血钾与血浆醛固酮水平呈负相关(r=-0.706,P=0.001)。结论:苏北地区原发性醛固酮增多症在高血压人群中占11.87%,在难治性高血压患者中占23.69%,因此在高血压患者中尤其是难治性高血压患者应常规检测血浆醛固酮/肾素活性比值以筛查原发性醛固酮增多症患者。Objective：To explore epidemiologic features of primary aldosteronism （PA） in northern Jiangsu and using plasma aldosterone/renin activity ratio （ARR） combined plasma aldosterone level to screen PA patients among pa-tients with hypertension .Methods：A total of 2014 inpatients and outpatients with hypertension were collected from our hospital .Radioimmunoassay was used to measure plasma levels of renin and aldosterone and blood biochemical indexes ,then ARR was calculated .PA was diagnosed when ARR〉240 and aldosterone〉150 pg/ml .Results：A to-tal of 239 patients （11. 87% ） were complicated with PA among the 2014 patients with hypertension ,and it occupied 23.69% （145/612） among patients with refractory hypertension .Compared with pure hypertension group ,there were significant reductions in renin activity [ （2.18 ± 2.54） ng·ml^-1·h^-1 vs .（0.68 ± 0.49） ng·ml^-1·h^-1] and serum potassium level [ （3.96 ± 0.45） mmol/L vs .（3.54 ± 0.45） mmol/L] ,significant rise in aldosterone level [ （132.99 ± 104.25） pg/ml vs .（272.55 ± 154.68） pg/ml] and ARR [ （118.40 ± 109.4） vs .（463.19 ± 251.85）] ,P〈0.05 or 〈0.01 ,and significant reduction in onset age of hypertension [ （49.37 ± 9.31） years vs .（39.69 ± 7.59） years] ,P〈0.01. Patients complicated with hypokalemia occupied 33.47% among PA patients ,linear correlation a-nalysis indicated that serum potassium level was correlated with aldosterone level （r= -0.706 , P=0.001） .Conclu-sion：In northern Jiangsu ,PA occupies 11.87% among patients with hypertension and it occupies 23.69% among patients with refractory hypertension .Therefore ,plasma ARR should be regularly detected to screen PA patients in patients with hypertension ,especially those with refractory hypertension .

关 键 词：醛固酮增多症 高血压 醛固酮 

分 类 号：R586.240.9[医药卫生—内分泌]